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Caught in Culture?Cultural Transformation through HIV/AIDS Prevention Education inZambiaEllen Carm

Academic dissertation for the Degree of Doctor of Philosophy in International Education atStockholm University to be publicly defended on Friday 31 March 2017 at 13.00 in Lillahörsalen, Naturhistoriska riksmuseet, Frescativägen 40.

AbstractThe study explores the role and contribution of education in developing a localized and relevant HIV/AIDS preventionstrategy through a multi-voiced approach, involving the educational institutions, as well as the traditional leaders,community-members, including parents. The study comprised all public schools in one Zambian province from 2002-2008. The study explores, among other factors, the role of traditional culture in mitigating and exacerbating the spread of thedisease.

Zambia was one of the countries hardest hit by the HIV/AIDs epidemic, and one of the few countries in the regionthat, in 2002, had a clear policy on the role of education in fighting the epidemic. Through the process of developing andimplementing a learner-centered interactive HIV/AIDS education program in the province. based upon MOE`s HIV/AIDSpolicies and strategies, syllabi, and teachers guides, and at the same time emphasizing the broader community as a pointof departure.

The qualitative and interpretivist research was conducted within a constructivist grounded theoretical approach. Thestudy applies comprehensive and multilayered perspectives while utilizing a broad range of methods. Documentaryanalyses, structured and semi-structured interviews, in depth conversations with traditional and educational leaders,teachers, parents and pupils, were all carried out during the period of the study. Nvivo, a computer-supported data analysistool was used to support the process of categorizing the qualitative data and the study applied Cultural- and HistoricalActivity Theory for analytic purposes.

The study revealed the mismatch between the decentralized, national HIV/AIDS prevention education approach, asstated in the policy documents and the global UNAIDS, centralized and cross-sectoral strategies favored by the Zambiangovernment. The uncoordinated efforts did not reach the grassroots level, where professionals, at district and school level,perceived and applied policies in highly different ways, if at all reaching students and the communities.

The main categories of drivers of the epidemic were of socio-cultural and economic character, e.g. polygamy,sexual cleansing, local healing, gender inequality and poverty, sexual violence, multiple concurrent sexual partners andprostitution, but there were also variety of local drivers, depending upon context.

When analyzing the participatory approaches of the HIV/AIDS prevention strategy, predominantly, at the school-community level, the findings revealed that the traditional leaders, being legitimate leaders in their kingdoms, and thecustodians of culture and traditions, were found to be gate openers to promote behavioral change and cultural transformationin their villages.

The traditional leaders worked hand in hand with the schools and the villagers. Their involvement legitimated thatdiscourses and HIV/AIDS prevention actions were taken at school as well as within their own chiefdom. Utilizing theirtraditional leadership structures, the chiefs sustained their cultural rites, e.g. cleansing, in order to chase away the evil spirits,by turning the rites into practices that do no put people at risk for contracting HIV. Particularly at the global and state level,culture has been seen as drivers of the epidemic. The study revealed that the traditional leaders used their role as significantothers, became gate-openers, using their legitimate role as custodians of culture to transform cultural rites and practices.

Keywords: HIV/AIDS prevention education, culture, transformation, multi-voiced and leveled strategy, culturalhistorical activity theory.

Stockholm 2017http://urn.kb.se/resolve?urn=urn:nbn:se:su:diva-138117

ISBN 978-91-7649-662-6ISBN 978-91-7649-663-3ISSN 0348-9523

Department of Education

Stockholm University, 106 91 Stockholm

Studies in Comparative and International Education

779

Caught in Culture?

Cultural Transformation through HIV/AIDS Prevention Education

in Zambia

Ellen Carm

Doctoral Thesis in International and Comparative Education

at Stockholm University Sweden 2017

Caught in Culture?

Cultural Transformation through HIV/AIDS Prevention Education in Zambia

Ellen Carm

Abstract The study explores the role and contribution of education in developing a localized and relevant HIV/AIDS prevention strategy through a multi-voiced approach, involving the educational institutions, as well as the traditional leaders, community-members, including parents. The study comprised all public schools in one Zambian province from 2002-2008. The study explores, among other factors, the role of traditional culture in mitigating and exacerbating the spread of the disease.

Zambia was one of the countries hardest hit by the HIV/AIDs epidemic, and one of the few countries in the region that, in 2002, had a clear policy on the role of education in fighting the epidemic. Through the process of developing and implementing a learner-centered interactive HIV/AIDS education program in the province based upon MOE’s HIV/AIDS policies and strategies, syllabi, and teachers guides, and at the same time emphasizing the broader community as a point of departure.

The qualitative and interpretivist research was conducted within a constructivist grounded theoretical approach. The study applies comprehensive and multilayered perspectives while utilizing a broad range of methods. Documentary analyses, structured and semi-structured interviews, in depth conversations with traditional and educational leaders, teachers, parents and pupils, were all carried out during the period of the study. Nvivo, a computer-supported data analysis tool was used to support the process of categorizing the qualitative data and the study applied Cultural- and Historical Activity Theory for analytic purposes.

The study revealed the mismatch between the decentralized, national HIV/AIDS prevention education approach, as stated in the policy documents and the global UNAIDS, centralized and cross-sectoral strategies favored by the Zambian government. The uncoordinated efforts did not reach the grassroots level, where professionals, at district and school level, perceived and applied policies in highly different ways, if at all reaching students and the communities.

The main categories of drivers of the epidemic were of socio-cultural and economic character, e.g. polygamy, sexual cleansing, local healing, gender inequality and poverty, sexual violence, multiple concurrent sexual partners and prostitution, but there were also variety of local drivers, depending upon context.

When analyzing the participatory approaches of the HIV/AIDS prevention strategy, predominantly, at the school-community level, the findings revealed that the traditional leaders, being legitimate leaders in their kingdoms, and the custodians of culture and traditions, were found to be gate openers to promote behavioral change and cultural transformation in their villages.

The traditional leaders worked hand in hand with the schools and the villagers. Their involvement legitimated that discourses and HIV/AIDS prevention actions were taken at school as well as within their own chiefdom. Utilizing their traditional leadership structures, the chiefs sustained their cultural rites, e.g. cleansing, in order to chase away the evil spirits, by turning the rites into practices that do no put people at risk for contracting HIV. Particularly at the global and state level culture has been seen as drivers of the epidemic. The study revealed that the traditional leaders used their role as significant others, became gate-openers, using their legitimate role as custodians of culture to transform cultural rites and practices.

Keywords: HIV/AIDS prevention education, culture, transformation, multi-voiced and leveled strategy, cultural historical activity theory

Acknowledgements

My journey as a PhD student in comparative and international education started when I was approved as a doctoral student at the Institute for International Education at Stockholm University in 1997. Many people, over the years, have contributed to the completion of this study. Without professional and personal support at various stages and in many different ways, this book would never have appeared.

Being a doctoral student while fully employed at Oslo and Akershus University College (HIOA) in Norway has created dilemmas and delays, but also created synergies and helped me broaden my perspectives. From 1997 to 2007, I was employed in a 50 percent position at the Centre for International Education at the college. It was at this time that Dr. Robert Langley Smith became my colleague and mentor. His guidance in the practical field of international education, aid and development, and his continuous support provided me with the courage to take on a Ph.D. program and ultimately finish it. My work as a consultant to NORAD where I conducted several missions and evaluations in the Global South, exposed me to my lengthy engagement in the HIV/AIDS mitigation efforts in MOE, Zambia.

I express my gratitude and acknowledgement to my supervisor Professor Emeritus Holger Daun, and docent Ulf Fredrikson over the last couple of years, spending considerable time reading the various chapters and guiding me to compile the final study. I want to thank colleagues from HIOA, Professor Leikny Øgrim and Professor Anders Breidlid for their inspiring and constructive comments and suggestions offered during the last leg of the study.

During my several, although short and memorable visits to IIE, I had the privilege of being part of the scholarly environment with world class colleagues. I am greatly indebted to Professor Emeritus Ingemar Fägerlind, Görel Strömquist, Professor Mina O`Dowd, Jared Odero, Dr. Reza Arjmand, Dr. Pia Karlson, Dr. Shuting Gao, Dr. Mikiko Cars and Dr. Christine Mc Nab for their intellectual generosity and the moral support they provided at different stages.

Long term development practitioner Joy du Plessis helped me to ground my theories in the development process and practices I studied. Curtis Reed enthusiastically and professionally proof-read the manuscript, and a special thanks to Dr. Shuting Gao for formatting the many iterations of the manuscript. Her skills have contributed to the quality of the layout of the thesis.

My Zambian colleagues and educators within MOE, from Head Quarters to school level, supporting and working with HIV/AIDS prevention within the project scrutinized in this study, in particular Bornwell, Stephany and Mike, have my deepest respect and gratitude for the lessons I learned from them while working together finding local solutions to the challenges of mitigating HIV/AIDS. A specific gratitude goes to the local leaders, chiefs, and their headmen taking an active part in the HIV/AIDS prevention activities. Without their hard work, their openness, assistance and commitment to the task we would not have accomplished our development goals.

Lastly, a special thank you to all my good friends for their long-standing moral support. Finally, the highest appreciation and love to my two brothers, Odd and Kjell and my nieces Kristina, Karolina and Hanna for their unwavering support.

Ellen Carm January 2017, Oslo

Abbreviations

AIDS Acquired Immune Deficiency Syndrome ALP Adaptable Lending Programme ARV Anti Retroviral Treatment AU African Union BESSIP Basic Education Sub-Sector Investment Plan BSA Britich South African company BSAC British South African Company CBO Community Based Organization DAC Development Assistance Committee (OECD) DDCC District Development Coordinating Committee DEB District Education Board DEBS District Education Board Secretary DEO District Education Office EFA Education for All FAWEZA Forum for African Women Educationalist, Zambia FBO Faith Based Organizations FPP Focal Point Persons (for HIV/AIDS education) FTA Foreign Technical Advisor GCE The Global Campaign for Education GDP Gross Development Production GDP Gross Domestic Product GER Gross Enrollment Ratio GTZ Deutsche Gesellschaft für Technische Zusammenarbeit HDI Human Development Index HIV Human Immunodeficiency Virus HIPC Highly Imdepted Poor Countries HM/W Head Man/ Women HOC House of Chiefs INGOs International Non-Governmental Organizations ISACA Interactive School-, and Community Approach MAP Multi-country AIDS Program MDGs Millennium Development Goals MOH Ministry of Health MTCT Mother to Child Transmission NAC National Aids Commission NEPAD New Partnership for Africa’s Development NET Net Enrollment Ration NGO Non-Governmental Organization NIF National Implementation Framework NORAD The Norwegian Agency for Development Cooperation

viii

PEO Provincial Education Office PEPFAR President’s Emergency Plan for AIDS Relief PLWHA People Living With HIV/AIDS PTAs Parent-Teacher Associations RFZ. Royal Foundation of Zambia SADC Southern African Development Community STI Sexually Transmitted Infections SWAP Sector Wide Approach UNAIDS United Nations Program on HIV/AIDS UNDESA United Nations department of Economic and Social Affairs UNGASS United Nations General Assembly Special Session UNIP United Nation Independent Party USAID United States Agency for International Development VCT Voluntary Counselling and Testing WB World Bank WLSA Women Law in Southern Africa ZDHS Zambia Demographic and Health Survey ZSBS Zambia Sexual Behavior Survey

Table of Contents

Abstract ...........................................................................................................................iii Acknowledgements ........................................................................................................v Map of Zambia ............................................................................................................. vi Abbreviations ............................................................................................................... vii Table of Contents ..........................................................................................................ix

Chapter 1 Introduction to the Study

1.0 Introduction ......................................................................................................1 1.1 Background .......................................................................................................2 1.2 Research themes ...............................................................................................9 1.3 Study aim, objectives and research questions ........................................... 10 1.4 Development discourses - global vs local .................................................. 11 1.5 Relevance of the study.................................................................................. 18 1.6 Limitations of the study ............................................................................... 20 1.7 Structure of the thesis ................................................................................... 21 1.8 Summary ......................................................................................................... 22

Chapter 2 The Context of the Study

2.1 Contextual background ................................................................................ 23 2.2 HIV and AIDS in Zambia ........................................................................... 27 2.3 Impacts of HIV and AIDS .......................................................................... 31 2.4 Overview of Zambian education history and policy ............................... 36 2.5 Educational structure and enrollment ....................................................... 40 2.6 Quality, access and completion ................................................................... 41 2.7 HIV/AIDS education .................................................................................. 44 2.8 Syllabus, content and methodology............................................................ 47 2.9 Concluding remarks ...................................................................................... 51

Chapter 3 Conceptual Framework

3.1 The structural, cultural and constructivist rationale ................................ 53 3.2 Conceptual framework ................................................................................. 55 3.3 Bio-ecological approach to development .................................................. 56 3.4 Culture, world-views, and world values ..................................................... 58 3.5 Epistemology of learning ............................................................................. 63 3.6 Communication in human activity and learning ...................................... 66 3.7 Explicit mediation and significance of schooling .................................... 70

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3.8 Cultural and Historical Activity Theory .................................................... 72 3.9 Summary ......................................................................................................... 82

Chapter 4 Research Methodology

4.1 Background and personal context of the research. ................................. 83 4.2 Dual role, advisor and researcher ............................................................... 88 4.3 Overall research approach. .......................................................................... 89 4.4 Sampling of data and sources of information .......................................... 91 4.5 Qualitative and constructivist grounded approach .................................. 97 4.6 Processing the data ....................................................................................... 99 4.7 Summary ....................................................................................................... 110

Chapter 5 Drivers of HIV/AIDS in Zambia

5.1 HIV/AIDS transmission ........................................................................... 111 5.2 Structural barriers and drivers of HIV/AIDS ........................................ 112 5.3 Traditional and cultural drivers of HIV/AIDS ...................................... 117 5.4 Stigma, power and discrimination ............................................................ 123 5.5 Concluding remarks .................................................................................... 126

Chapter 6 Role of Traditional Leaders

6.1 Traditional rulers, chiefs and kingdoms in Africa .................................. 127 6.2 Traditional leaders and governance in Zambia ...................................... 132 6.3 Chiefs’ role in fighting HIV/AIDS .......................................................... 137 6.4 Concluding remarks .................................................................................... 139

Chapter 7 HIV/AIDS Prevention prior to the Project Intervention

7.1 School surveys ............................................................................................. 141 7.2 Local context and Zambian HIV/AIDS education prevention .......... 160 7.3 National HIV/AIDS policies and strategies ........................................... 163 7.4 Summary ....................................................................................................... 174

Chapter 8 Multi-voiced Planning and Negotiations of Interventions

8.1 Common visioning...................................................................................... 177 8.2 Overall strategy, processes and responsibilities ...................................... 182 8.3 Impact on culture and traditions .............................................................. 191 8.4 Impacts on MOE activities ........................................................................ 196 8.5 The new objective of activity .................................................................... 197 8.6 Summary ....................................................................................................... 200

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Chapter 9 Change and Transformation

9.1 Traditional leaders’ contribution to cultural transformation ................ 203 9.2 Applying and implementing MOE’s HIV/AIDS education

policies and strategies ................................................................................. 218 9.3 Summary ....................................................................................................... 231

Chapter 10 Key Findings and Contributions

10.1 Key findings ................................................................................................. 233 10.2 Contributions to development research and practice ........................... 243 10.3 Reflections on future development research .......................................... 245

Summary of the Study .............................................................................................. 249 Sammanfattning ......................................................................................................... 261 References .................................................................................................................. 273

Appendices Appendix A: Selected demographic indicators ............................................. 287 Appendix B: Estimated annual HIV incidence ............................................. 288 Appendix C: Zambian education structure ................................................... 289 Appendix D: Basic education indicators ........................................................ 290 Appendix E: HIV/AIDS as addressed in the syllabi ................................... 291 Appendix F: AIDs timeline 1981-2006 .......................................................... 293 Appendix G: Global Campaign for Education (GCE 2005) ...................... 294 Appendix H: Partnerships in the National Response .................................. 296 Appendix I: Baseline survey tools .................................................................. 297 Appendix J: Quarterly monitoring of HIV/AIDS activities. .................... 300

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List of Tables Table 2.1 Estimates of HIV infections in Zambia 2001 to 2009 ...................... 28 Table 2.2 Southern province estimated HIV prevalence by district

from 1985-2010 ....................................................................................... 29 Table 2.3 Life expectancy at birth by year ............................................................ 31 Table 2.4 Deaths among teachers due to AIDS .................................................. 35 Table 2.5 Number of schools by agency ............................................................... 41 Table 2.6 Number of children dropped, or pushed out of school by grade ... 43 Table 3.1 Typology of Western and African planning processes...................... 62 Table 3.2 Established and situated conceptualizations of learning ................... 65 Table 4.1 Types of research data collected by year ............................................. 93 Table 7.1 A summary of the survey ..................................................................... 153 Table 7.2 Drivers of the HIV/AIDS epidemic ................................................. 161 Table 10.1 Type of contradictions, characteristics and their manifestations ... 236 Table 10.2 Contradictions and solutions evolving out of program activities. . 239

List of Figures Figure 2.1 Overview of Zambian HIV/AIDs prevalence ................................... 25 Figure 2.2 Structure of the educational system ..................................................... 40 Figure 3.1 The conceptual framework .................................................................... 55 Figure 3.2 Two interacting activity systems ........................................................... 73 Figure 3.3 Strategic learning actions and corresponding contradictions

in the cycle of expansive learning ......................................................... 76 Figure 3.4 Classification of contradictions ............................................................. 78 Figure 4.1 Overview of the sequences and scaling up of the main activities. .. 86 Figure 4.2 Overview of the main project and research activities ....................... 90 Figure 4.3 Complex and relational HIV/AIDS discourses ............................... 104 Figure 4.4 Nodes reflecting cultural practices and traditions………………..105 Figure 4.5 Emerging categories based upon nodes related to HIV/AIDS

prevention education ............................................................................ 105 Figure 6.1 Structure of a chiefdom ........................................................................ 136 Figure 7.1 The traditional Zambian community ................................................. 144 Figure 7.2 The school community ......................................................................... 145 Figure 7.3 Two interacting activity systems ......................................................... 146 Figure 8.1 Ilustration of participants in the multivoiced planning process .... 178 Figure 10.3 The two interacting activity systems; The traditional- and

the school-community. ......................................................................... 245 Figure 10.4 The merger of a global and a local HIV/AIDS prevention

education strategy .................................................................................. 246

Chapter 1

Introduction to the Study

1.0 Introduction In 1998, the Norwegian Agency for Development (NORAD) appointed me to their Zambian team, working with the on-going education sector reform program in Zambia, the Basic Education Sub-Sector Investment Plan (BESSIP) emphasizing equity, partnership and coordination as critical means to improve the quality of learning (Musonda, 2003). This was my first direct experience with the devastating impact of the Human Immunodeficiency Virus /Acquired Immune Deficiency Syndrome (HIV/AIDS) epidemic, and it became very personal when one of our senior Zambian partners passed away from the illness just before my second visit to Zambia. Throughout my four-year engagement with the team, I served as an educational advisor during the process of negotiating and approving an education sector plan between the international and bilateral donors and the Ministry of Education (MOE). During this time, the HIV/AIDS crisis escalated, and in 2001 approximately 750,000-900,000 adults and children were infected (UNGASS, 2010, p. xviii). Serious concerns about the epidemic and the impact, not just at individual, but also at the national level were raised among researchers, educators and political leaders during these preparatory meetings in Zambia. Ultimately, HIV/AIDS became a cross cutting theme within the final BESSIP strategy.

During that period, I also conducted a literature review on the HIV/AIDS epidemic in Sub-Sahara on behalf of NORAD. Notably, I discovered that HIV/AIDS prevention was considered a health issue. The ministries of health were in the forefront, and the interventions were focusing on care and treatment targeting those who had acquired AIDS (Carm et al., 1999). At the same time, I found that the educational sector was more or less absent from the fight against HIV/AIDS. Educational prevention efforts were missing or at in the background. The schools, the teachers and structures were in place for MOE to reach out to students and their communities throughout the country, but in spite

Caught in Culture? 2

of that, the education sector was not involved. What seemed to be missing was the development and implementation of comprehensive educational strategies to ensure that HIV/AIDS prevention and information reached pupils and community members at the local level. Given this context, HIV/AIDS prevention was given priority by donors supporting the Basic Education Sub Sector Investment Program (BESSIP), including NORAD and Zambia’s Ministry of Education (MOE). Subsequently, HIV/AIDs prevention was included in the education sub-sector policy in Zambia.

My journey in Zambia continued, as I was asked to support a teacher training college, in 2000, and thereafter 2002, all the primary schools in the province, in developing and implementing HIV/AIDS education, based upon the new Zambian HIV/AIDS education prevention policies. The present study focuses on the challenge politicians and educators encountered while trying to educate students and the communities about HIV/AIDS prevention. The study explores qualitative data that was collected over a 6 years period, from 2002 until 2008, when I was actively engaged in the HIV/AIDS mitigation interventions scrutinized in this study. The Zambian HIV/AIDS policies and strategies referred to in the theses therefore, reflect and represent the contextual realities and frameworks relevant for that specific period, as the interventions were developed and aligned within those structures.

The study focuses primarily on rural and semi-rural of Zambia. I will explore the main themes: educational outreach efforts related to HIV/AIDS prevention, the alignment of global HIV/AIDS strategies with Zambian policies and implementation procedures, and the dynamics of participatory and locally negotiated solutions. This study sheds light on the influences local cultures, traditions, knowledges and practices have on local development and transformation. Furthermore, the study illustrates the complexity of national development in an increasingly globalized context. This study discusses this complexity both at the global level and within different national approaches taken to prevent the spread of HIV/AIDS.

1.1 Background It has been more than 30 years since the Acquired Immunodeficiency Syndrome (AIDS) emerged as a major health emergency. The epidemic has had a serious, and in many places, devastating effect on human development. The epidemic’s impact has varied from place to place and country to country, but has been documented with increasing precision over the years as surveillance and analytical tools have improved. As a result, the interrelationship of AIDS with other problems of human development has become clearer. The late Jonathan Mann’s insight from the early 1990s, that “AIDS shines a spotlight on human rights and societal issues, has been borne out in many ways, particularly in the epidemic’s interactions with poverty, gender inequality and social exclusion” (Mann et al.,

Introduction to the Study 3

1994 in United Nations Program on HIV/AIDS (UNAIDS), 2006d, p. 80). Research over the past ten years has also shown how AIDS exacerbates other major challenges to development, from the deterioration of public services and governance, to humanitarian emergencies such as food insecurity, poverty and conflict. For the past three decades, HIV/AIDS has spread across all continents, killing millions of adults and children, disrupting family life and entrenching poverty, orphaning millions of children, weakening the workforce, and threatening the social and economic development of communities and nations.

Statistical updates from UNAIDS (2016) estimate that since the beginning of the epidemic, approximately 80 million people have been infected with HIV and about 35 million people have died of HIV-related causes, approximately 1,1 mill died from AIDS in 2015, while approximately 37 million people globally were living with HIV. Most of them live in the world’s poorest countries. HIV, also called “global killer” (Oxfam, 2008) is fueled by poverty and thereby turn into a major threat to development as well as devastating family and community efforts to improve their livelihood.

Even though there have been, and still is, a tremendous increase in those receiving Anti-Retroviral drugs (ARVs), there were 2.1 million people worldwide that newly infected with HIV in 2015. This is a reduction from 2.2 million new infections in 2010, the year characterized as the peak of the epidemic (UNAIDS, 2016).

The HIV epidemic in the Sub-Saharan Africa region was fairly stable until 2010 (UNAIDS, 2010), and the region was the most affected in the world with an estimated 22 million people living with HIV in 2009, representing 68 percent of the global HIV burden. The 10 countries worst affected were in southern Africa, and included 34 percent of all people living with HIV in 2009 (UNAIDS, 2010). Eastern and southern Africa now accounts for 46 percent of the global total of new HIV infections (UNAIDS, 2016), in spite of the fact that new HIV infections declined by 14 percent between 2010 and 2015 (ibid.).

The last statistics from UNAIDS (2016) show that there were 19 million people living with HIV in eastern and southern Africa in 2015, where women account for more than half the total number of people living with HIV.

At the time of the intervention, four countries, Ethiopia, South Africa, Zambia and Zimbabwe were among the countries in sub-Saharan Africa with the largest HIV epidemics, although the number of new HIV infections were reduced with approximately 25 percent between 2001 and 2009, (UNAIDS, 2010, p.3).

According to UNAIDS (2010) allthough women make up more than half of the total number of people living with the virus, sub-Saharan Africa is accounting for as much as 76 percent of all women living with HIV globally. The feminization of HIV/AIDS has become a growing concern and the vulnerability of women and girls to HIV remains particularly high in sub-Saharan Africa. In sub-Saharan Africa alone, the epidemic has orphaned nearly 12 million children under the age of 18. The natural age distribution in many national populations in


sub-Saharan Africa have been dramatically skewed by HIV and AIDS over the last decades with potentially dramatic consequences for the transfer of knowledge and values from one generation to the next.

Throughout Africa, the HIV/AIDS epidemic has created diverse problems. Whilst families and communities struggle to cope with the emotional and economic burden of sickness and death, today's children face problems that will affect them throughout their lives. Having a sick parent and being orphaned leaves children vulnerable to malnutrition and illnesses which have a negative impact on their access to education and training, as well as their social development. The trauma and distress of HIV/AIDS is hard to bear but often also made worse by the stigma and even discrimination faced by those affected by HIV/AIDS.

The various impacts of AIDS are still not fully understood particularly when the long term is considered. As stated by Barnett and Whiteside (2002, in UNAIDS, 2006d, p.80), “The epidemic comes in successive waves, with the first wave being HIV infection, followed several years later by a wave of opportunistic diseases, and later still by a wave of AIDS illness and then death”. The final wave affects societies and economies at various levels, from the family and community to the national and international levels. None of the highly affected countries has yet hit the peak of the third wave nor advanced very far into the fourth, and as one study put it,

We do not know how severe the impacts of the third and fourth waves will be; little about this pandemic is linear and AIDS is a unique threat. What, for example, is the likely long-term social, economic, and psychological damage, wrought by the orphaning of millions of children? What we do know is that impacts will continue to be felt for years to come and the situation will get significantly worse before it gets better (Bell et al. 2003, in UNAIDS, 2006a, p.81).

In the countries most heavily affected, HIV has reduced life expectancy by more than 20 years, slowed economic growth, and increased household poverty. According to the United Nations Development Program (UNDP), HIV has inflicted the greatest reversal in human development in modern history (UNDP, 2007b).

Social, cultural, economic and legal factors exacerbate the spread of HIV and heighten the impact of HIV/AIDS. In almost all cases, poor and socially marginalized people are disproportionately vulnerable to HIV/AIDS and its consequences. The UN Millennium Declaration, and the goals it sets, highlights the interconnectedness between development goals and the need to address the causes of vulnerability to HIV/AIDS and its impacts, by alleviating poverty through sustainable development, the promotion of gender equality and access to education. The overwhelming burden of the epidemic is borne by developing countries, where the vast majority of the people most affected by, and vulnerable


to, HIV/AIDS do not have access to even a basic set of HIV prevention, treatment, care and support services and programs (Oxfam, 2004, p.15).

Millennium Development Goal (MDG) 6 states that, by 2015, the world will have halted and begun to reverse the global HIV epidemic (UNAIDS, 2008). UNDP stated that, “By making the HIV response one of the overriding international priorities for the 21st century, world leaders acknowledged the centrality of the HIV response to the future health and well-being of our increasingly interconnected planet” (UNDP, 2005 in UNAIDS, 2008, p.13). In the Political Declaration on HIV/AIDS the UN Member States have committed themselves to taking extraordinary action to move towards universal access to HIV prevention, treatment, care, and support by 2010 (UNAIDS, 2008). But the donor governments’ disbursements for the AIDS response in 2009 were US$ 7.6 billion, a reduction compared to the US$ 7.7 billion available in 2008 (UNAIDS, 2010).

At the individual and national level in most developing countries, it remains a salient point, however, that the HIV epidemic cannot be reversed without strong, sustained success in preventing new HIV infections. Development efforts at preventing new HIV infections have however, lagged seriously. According to UNDP (2007, p.96), in spite of the fact that, “87 percent of countries with targets for universal access [to education] have established goals for HIV treatment, only about 50 percent of these countries have targets for key HIV prevention strategies.” (ibid). In many countries, especially in sub-Saharan Africa, AIDS is undermining progress towards the MDGs, particularly those related to poverty reduction, achieving universal primary education, promoting gender equality, reducing child mortality and improving the health of mothers (UNFPA, 2003, UNESCO, 2007).

Education has been identified as a “social vaccine” by e.g. Kelly, (2000) and The World Bank (2004) as HIV/AIDS prevention education equips young people with invaluable tools to increase self-confidence, social and negotiation skills to improve learning, earning capacity and family well-being, to fight poverty and to promote social progress. As education has a key role to play in preventing HIV/AIDS and in mitigating its effects on society, it also calls for expanded action for improved HIV/AIDS information through education. Due to the sector’s capacity to reach out to a large number of young people with life-saving information, the education sector appears to be paralyzed where out of 18 African countries studied only two countries had a strategy for using their education sector in the fight against AIDS1. (Global Campaign for Education, 2005). The same criticism is also shared by others, e.g. UNESCO (2008) considering the vital core of providing information about the epidemic through the schools by also equipping teachers with the right skills and attitudes to teach HIV and AIDS education.

1 Zambia was one out of these two countries with a policy in place.


Education as a social vaccine

Basic education has a powerful preventive effect, and therefore been described as a “social vaccine” (Kelly, 2000), which has proven to be the case regardless of whether HIV/AIDS has been a part of the curriculum or not (GCE, 2005; Kelly, 2000; Shenker, 2006). According to GCE (2005) educational systems have a critical role to play in fighting the epidemic, because of their capacity to reach very large numbers of young people with life-saving information and skills.

Research shows that in general, there are clear benefits of extended years of schooling on HIV/AIDS infection rates and on behavior change in adolescents (Schenker, 2006). There is also a correlation between number of years in school and a decline in HIV/AIDS prevalence (Fylkesnes et al. 1998, 2004). A complete primary education can, halve the risk of HIV infection for young people. Evidence shows that young people with little or no education are 2.2 times more likely to be infected by HIV than those who have completed primary education (Boler & Jellema, 2005).

Research by Michelo et.a. (2006) shows the link between education and HIV prevalence in Zambia, over a period from 1995-2003. The findings revealed a changing pattern of HIV prevalence by educational attainment, showing a marked risk reduction among more educated younger groups during the period 1995–2003 where most infections can be assumed to have been acquired recently. Education uniquely appeared to be an effective preventive factor in reducing the likelihood of HIV infection in both sexes among young people. This is in contrast to findings in earlier studies in which higher educational attainment was associated with higher risk of infection and showed a differential picture by gender. The change among higher educated groups were found in both rural and urban areas as well as between young women and men with similar educational level, suggesting that education may have been the factor behind this reduction in both sexes (ibid.).

In Zambia, research by Kelly (2010) revealed that girls completing high school were three times less likely to contract HIV than those who dropped out of school. It is believed that education in general even without special HIV education, equips individuals with skills needed to understand information and to evaluate situations that can prevent them from being infected (Boler & Jellema, 2005; Kelly, 2008). Moreover, education contributes to dismantling poverty, increasing self-confidence and raising one’s social status, which all are contributing factors to increased control over sexual choices, especially for young women (Boler & Jellema, 2005, Michelo et al., 2006).

Kelly (2008), Shenker (2006, p.13-14) and Michelo et al., (2006) further argue that participation in schooling leads to sexual behavior starting later in life and lower numbers of casual sexual partners and that education increases access to information: both to HIV related materials in school, and better access to such material later in life. Education is also a confounder for socio-economic status: richer learners are more likely to stay in the formal education sector and may be


in a better position of power to protect themselves from HIV infection. A study conducted in Uganda over the course of the 1990s showed that both women and men who finished secondary school were seven times less likely to contract HIV than those who received little or no schooling (ibid. p.13).

From a gender perspective, a 32-country study found that women with post-primary education were five times more likely to know facts about HIV/AIDS than was the case for illiterate women. Illiterate women, on the other hand, were four times more likely to believe that there is no way to prevent HIV infection (Vandermoortele & Delamonica 2000, in Schenker, 2006). In Zambia, during the 1990s, HIV infection rates fell by almost half among educated women but showed little decline for women with no formal schooling (Fylkesnes et al. 1998; Kelly, 2004). According to UNICEF, (2003, in Shenker 2006, p.12) “Other studies have shown that in Zambia, the more schooling young people have, the less likely they are to have casual partners and the more likely they are to use condoms”, also confirming the positive correlation between education and reduced risk of contracting HIV/AIDS.

There is a predominant view that the school curricula should include HIV/AIDS education, focusing on HIV/AIDS education, care, treatment, fighting stigma and discrimination, gender inequalities and human rights (Kelly 2000, GCE 2005). The trends seem to be to integrate the topic as part of a more concerted focus on life skills (UNESCO, 2008). The declaration of the United Nations General Assembly on HIV/AIDS recommended that global targets for 2010 be set to 95 percent of 15-24 year olds should be guaranteed 24 hours access to the information and services necessary to develop the life skills required to reduce their vulnerability to HIV infection. They also address the need to move beyond the formal education sector and emphasize reaching out through non-formal and informal means, targeting groups from ages 15-24 (Schenker, 2006).

A study conducted by Boler (2003) compared HIV/AIDS education in some Kenyan and Indian schools. Their study revealed that where HIV/AIDS was taught the critical factor determining which content was presented to the learners was the individual teacher. The main findings from the study on teaching practices showed that while 95 percent of the teachers claimed they were teaching HIV/AIDs but only 57 percent of their students said they ever had heard about HIV/AIDS at school. Action Aid found that the teachers rather seem to practice what they called “an overly scientific approach” to HIV/AIDS, talking about the medical, clinical and nutritional aspects of HIV and AIDS. This also explains, the report further argues, why 35 percent of the pupils in India and 7 percent in Kenya reported having been taught about HIV/AIDS but never having been taught about sex.

Boler (2003) coined the term “selective teaching”, referring to teacher practices of concentrating their teaching around areas characterized as a scientific approach, rather than a contextualized and cultural specific. By doing that, the ongoing HIV/AIDS education did not stimulate children to understand the human side of HIV in context, nor enable them to connect the issues to the real-


life settings and encourage them to communicate openly and accurately on the HIV/AID epidemic, the spread, the causes and prevention (ibid.).

Since there still is no cure or vaccine against HIV, it is a growing recognition that prevention is critical. It is even more critical that the prevention requires more than just health information. The prevention should help people change behaviors that put them at risk. Behaviors are embedded in deep cultural and social patterns (Boler & Jellema, 2005) and education that addresses these in culturally and socially acceptable ways has the most chance of being effective. The study by Michelo et al. (2006) in Zambia, revealed that in the 15-25 year-old-respondents, the availability of “HIV preventive information was useful in forming their sexual behavior, as they became sexually active after this critical information became well known” (ibid. p.1037).

Educational institutions have the potential to be effective at passing and promoting HIV and AIDS information, because they reach youth at the right time, namely when they are still open for change in their behaviors, values and beliefs. However, research has revealed that provision of knowledge alone cannot lead to behavior change unless it is accompanied by acquisition of skills (Coombe and Kelly, 2001, Kelly, 2008), but, they further argue, effective HIV education can only take place when the social-cultural issues that increase the spread of HIV are addressed, as well as focusing on social-economic gender inequality.

During the last 30 years, it has become clear that turning the negative tide of the epidemic is not an easy fix. The Executive Director of UNAIDS, Dr Peter Piot in his speech to the Toronto Conference, ‘Time to Deliver’ (2007) noted that: “It is time now that we move from crisis management to long term sustainable results and that we start thinking of the response to AIDS in decades, in generations perhaps, and not one year after another” (Mulaudzi, 2007, p.106).

Individual and social change is a complex and dynamic process, it is contextually bound and influenced by external as well as local forces, initiated from within, from the bottom-up, or imposed from above - top down. It is widely recognized that in order to fight the HIV/AIDs pandemic, societies and individuals need to change their way of living together, their sexual norms, and behavior. Individual change is heavily interrelated with social and cultural norms and values that guide individual behavior, consciously or unconsciously. Therefore, Kelly (2000b) argues that education in a world with HIV/AIDS requires a radical shift in the educational approaches, content wise as well as the processes and methods applied. The role of the schools needs to be radically altered to also incorporate non-formal approaches and community-based actions in order to respond adequately and efficiently to the existing HIV/AIDS epidemic (ibid).


1.2 Research themes Because of the current needs and challenges required to fight and prevent the spread of HIV/AIDS, the present study focuses on exploring change-oriented learning processes that are grounded in the lived reality of people in a context where HIV/AIDS is either impacting, or affecting the whole population. The dialectic relationship between tradition and modernity, cultural practices and scientific knowledge in Zambia, also emphasizes the need for including a plurality of perspectives in the design of a relevant and situated approach to school, and community-based approaches to HIV/AIDS education and prevention.

The study explores the relationships between “The higher and lower geographic levels (and how they) mutually influence and shape each other as in the ‘dialectic of the global and the local” (Arnove et. al. 2003, p.1). Manzon (2007) points to the relative strengths and weaknesses of analyses limited to one level of the geographic hierarchy, e.g school versus district or national level. These perspectives are consistent with the views of Serpell (1993) and Darnell et. al. (1996) pointing to the importance of multilevel perspectives, exploring the link between national, local and environmental cultural conditions in order to gain a comprehensive understanding of the complex reality of educational phenomena. Manson further refers to Sadler (1900, in Manzon, 2007, p.120) who also cautioned that: “the things outside the schools matter even more than the things inside schools, and govern and interpret the things inside”. This refers to the need for lower level studies (individual, classroom, and school) to be understood within the broader context of higher levels of the framework (system, state, etc.). Only in this way can studies present a meaningful and comprehensive picture of the relationships between macro and micro levels (ibid.).

The research therefore aims at understanding the intersection of global and local development discourses and the influence of this nexus on local actions. It further focuses on a participatory approach to development, by investigating the learning processes at hand during the development and implementation of the national HIV/AIDS education strategy in Zambia, enhancing a localized and participatory approach to development with a specific focus on culture and the role of local leaders. The study further explores some of the multi-layered issues related to HIV/AIDS prevention by investigating the complex nature of national development in a globalized context in general. This is exemplified by investigating how the global UNAIDS strategy was applied and implemented locally through the Zambian National Aids Commission (NAC) framework and the national HIV/AIDS education prevention strategy developed within the umbrella of the education policy, Educating our Future (MOE, 1996). The Zambian approach is further specified within the educational sub-sector plan BESSIP, as it unfolded during the research period, from 2002-2008.

An ecological approach allows the researcher to look into different aspects of human development (Bronfenbrenner, 1979, 1999, 2005). The individual, at the micro level, is interacting with the family and local community as it is the


closest social environment for cultural transformation. The school, other institutions and the broader environments further comprise what is defined as the eso-level, where the individual expands its actions, being influenced and interacting with a broader societal network. National as well as global influences also play an important role in the socialization process through formal, non-formal and informal learning, in this study, understood as Bronfrenbrenner’s macro level. Furthermore, the study examines the role that cultural, traditional and contextual realities play in creating the lived experience of individuals. Connections between and across these different institutions, actors and world-views create the complex learning environment, meso-level interactions.

The study further draws on the principles of the third generation of Cultural and Historical Activity Theory (CHAT), developed by Engeström (1987, 2001a, 2008a, b). CHAT was used as a tool for analyzing the findings that emerged from NVIVO, used for explorations and categorization of the data. These issues will be further elaborated on in Chapter 4.

1.3 Study aim, objectives and research questions The overall aim of the study is to explore the process of change in relation to HIV/AIDS prevention thereby contributing to the understanding of the influences of local culture, traditions, knowledge and practices. This is done by analysing the HIV/AIDS education policy and strategy developed within BESSIP, and its implementation. The ‘foreshadowed problem’ of the study is the challenge of adapting and adopting contextualized and traditional approaches to societal change to address a ‘modern’ health and social crisis.

The study therefore has three main objectives:

a) To explore the contextual realities of the HIV/AIDS epidemic in Zambia and how the MOE HIV/AIDS education strategies were perceived, experienced and practiced among the key stakeholders during the time of the project inception.

b) To identify how broad participatory stakeholder involvement could bring out innovative HIV/AIDS strategies to mitigate the drivers of the epidemic responding to the contextual realities.

c) To explore how culture can mediate change and create local innovations through expansive learning across professional and cultural traditional boundaries and borders.

The specific research questions addressed are as follows: 1. What were the contextual realities of the HIV/AIDS epidemic in

Zambia, during the period from 2002-2008 and how were MOE HIV/AIDS education strategies perceived among key stakeholders?


2. To what extent did negotiations between the broad diversity of stakeholders contribute to a localized HIV/AIDS intervention leading to innovative and localized strategies?

3. What was the impact of the local interventions at school and community level? How did change and transformation manifest themselves during the project interventions?

The thesis incorporates findings from a broad array of academic research, documents from policymakers and I/NGO, minutes of meetings and empirical data from the core project respondents and activities. The study brings out in-depth knowledge about the dynamics and links between local transformation and development, e.g. the role of traditions, local practices and indigenous knowledges, and its interaction with a global development agenda, reflected through its national application in Zambia. The next subchapter therefore highlights some of these discourses while emphasizing the global HIV/AIDS prevention agwenda through UNAIDS.

1.4 Development discourses - global vs local The fight against HIV/AIDS must be a long-term commitment from international, governmental, public, private and local actors. The need for multiple long term and holistic approaches to combat the epidemic has been recognized globally. The approaches to development challenges, including combatting HIV/AIDS, however, are contested. Halting the spread of HIV/AIDS was among the eight Millenium Development Goals (MDGs) endorsed by political leaders from 189 countries at the Millennium Summit in September 20001. The global perspectives on eradicating HIV/AIDS was reflected in the Millenium Project that advocated scaling up the support to the global effort to address the main constraints crucial for development and economic growth. One of the pre-requisites, according the the Millenium Project, is for industrialized countries to keep their promise of providing 0.7 percent of their Gross Domestic Product (GDP) to development assistance (Sachs, 2005, Pellini, 2007). The leader of the Millenium Project, the United Nation (UN) secretary general should run the plan, coordinate the actions, jointly with the country teams, the World Bank (WB), the International Monetary Fund (IMF) and a couple of dozen rich-country aid agencies (Easterly, 2006, p.6).

This illustrates an institutionalist perspective that assumes the existence of a world polity, or world models for education consisting of “cognitive and ontological models of reality that specify the nature, purposes, technology, sovereignty, control and resources of nation-states and other actors” (Mayer et al 1997, p.144 in Daun and Mundy, 2011, p.5). The world models suggest some common standards and strategies for educational development, including

1 See: http://www.unmillenniumproject.org/goals/


decentralization, school-based management and privatization among others (ibid.). As Vidharty (2008) states, development is a process of change, whether it comes from within focusing on the individual as agent for change; from the grassroots; (bottom up) or through an institution or an organization. It may be a nationwide initiative or introduced through external support.

Critics of current development approaches argue that the strategies and policies designed, as “Big Plans” (Easterly, 2006, p.10) have not worked and that we need to learn from our past efforts. Easterly blames the advocates of the traditional approach, called -The Planners-, for having good intentions, but that they have not motivated anyone to carry them out; nor is there any accountability for meeting the goals. He decries approaches that lack bottom up knowledge, and leaves outsiders to determine solutions to local problems (ibid.).

Easterly (2006) does not question the good intentions of the proponents of these policies but does question their effects, stating that, “Simply having these policies may be sufficient for compensatory legitimation; fulfilling them, judging by past experience, seems to be less important” (Klees, 2008, p.8).

The answer to the failed development of the “Big Plans”, according to Easterly (2006) is the need for “the Searchers”, replacing the global models, as an alternative (p.5-6). This approach calls upon local agents of change, who have sought out alternative approaches to the Big Plans. Searchers, according to Easterly, will act as guides to a constructive approach to foreign aid, finding things that work, accept[ing] responsibility for their actions, find[ing] out the local demands and adapt[ing] to local conditions. Searchers find out what the reality is at the bottom, and focus on the need of involving a broad participation of insiders with the contextual knowledge needed to find a solution, a solution that must be homegrown.

In education, perhaps the best-developed critical alternative approach to the macro level models is rooted in the work of Paulo Freire and elaborated in an extensive literature on critical pedagogy (McLaren and Kincheloe, 2007). This is supported by Klees (2008) arguing that, “Critics place a lot of faith in human agency to take advantage of those spaces – human agency being the individual and collective transformative choices and actions of those who share a critical perspective” (ibid., p.9).

The development debate is far more complex than what is being reflected above, but the debate is still open, and the challenges remain. The Global Monitoring Report (UNESCO, 2007) in assessing the MDG achievements against the target indicators, are questioning whether the right actions are being taken, and whether the actions are being undertaken in the right manner to be sufficiently scaled up to really make a difference (UNESCO, 2007).

Today it is recognized that there is not a proven blueprint formula that can be rolled out in country after country like some kind of a development franchise to reach the targets. To characterize these top-down, global approaches, different authors use the concepts “global architectures”, it being of education or health (Breidlid, 2013). Jacobs (2002, in Pellini 2007, p.19) argues that, “The complexity


of development processes cannot be adjusted on a linear path, as argued by modernization theorists and it must be understood as “qualitative change” that involves, besides economic growth, social as well as cultural changes.”

There is wide acknowledgment that culture needs to be considered in development work. The way we perceive and understand our everyday way of life, the “just taken for granted” ways of behaving, relate to our environment, and solving our problems is understood and experienced accordingly (Berger and Luckman, 1967). In particular, recent HIV and AIDS prevention strategies include a broader understanding of the importance of social context and culture and show that engaging with culture can strengthen development communication programming (Aggleton, 2003, Findings, 2005).

Recognition of the central role of culture is long overdue, begging the question of how development work could have neglected culture for so long. A cultural lens highlights how the practices and assumptions of international development institutions are themselves shaped by culture and reveals the need for an adequate understanding of power and the character of social change at all levels of development practice (Findings, 2005, p.1).

For development programs to be relevant, sustainable and have an impact on ways of living, the development partners have to promote planning processes where local knowledge and culture are considered equally important as those being forwarded by the external experts (Breidlid, 2013, Chambers, 2008; Freire, 2000). People are inclined in their lived world, to be controlled and guided by their cultural heritage. External environmental factors or events may suddenly disturb their lived world, as might be the case if new technologies are being applied (Engeström, 2001, 2008). These external interventions create disturbances in otherwise structured and culturally applied norms and practices. To challenge traditional practices and beliefs can also also be threatening to societies in which ancestors’ beliefs and traditions and cultures are adhered to. In this sense, people might be caught in cultural practices that actually may threaten the existence of their own cultural existence.

It is in this context that participatory development is an effort to restore power to local people and encourage them to take the initiative, make decisions, formulate, and implement activities and programs concerning their own future. It consists of recognizing that the people are creators and partners who are responsible for their own development. In so doing, the promotion of participa-tion therefore means instituting a partnership, a contractual relationship among the various agents of development, in particular between the people concerned and those intervening from the outside (Shaeffer, 1994). Promoting and aiming at a more participatory approach to development begins with the assumption that “sustainable development ultimately depends on enhancing people's capacities as individuals and groups to improve their own lives and to take greater control over their own destinies (Ogun, 1982, in Shaeffer, 1994).


A participatory approach to development represents a change in the process of governance, in social and political relationships, and in who participates in, controls, and is empowered by the development process. As Chambers and Pettit (2004, p.150) argue, “it is not a question of who is empowered to do what” it is also a question of who might have the space and discretion to determine and develop the ways things are done. A great challenge is to see where that space can be opened up and how creatively it can be utilized. The ultimate achievement is when people devise good procedures for themselves.

Through such processes, there is also a scope for agency in empowering others (Chambers, 2008, Chambers and Pettit, 2004, Freire, 2000, Shaeffer 1994). The process is similar to those methods taken to empower others to change institutions, procedures, practices and behaviors through devolution and participation. Chambers and Petit (2004, p.155) argue that, “Excessive top-down controls freeze systems, which then misfit local conditions”. The aim is not total control or total devolution, but managing diversity, coordinating variety and thereby releasing potential. For this to happen, devolution with minimum controls can empower, create space for participation, and encourage diverse, decentralized and dynamic behavior that fits local conditions and enhance ownership.

Individual, social and cultural change processes are complex, multi-leveled, and cannot be reduced to the rational, transparent intentions of individuals. Due to the complexity and unpredictability of qualitative change it can be described as an open-ended process, not to be thought of as a linear process or even a collection of open ended lines. It operates as a web of interdependent co-developments (Findings, 2005). How to confront or rather, how to acknowledge and meet the local cultures in a multicultural and appropriate manner is another complex challenge in the discourse of sustainable development.

It is commonly agreed that in responding to HIV and AIDS, several domains of contexts need to be addressed to sustain changes in behavior: spirituality, gender, socio-economic status, policy and culture (UNAIDS, 2002, 2006, UNDP, 2003, UNESCO, 2006a). TAARN (2004) argues that culture is too often seen only as a barrier to change (Ray et al. 2005). Instead of viewing culture as a barrier one should rather build upon culture and traditions with the aim of utilizing culture for development, as also supported by Aggleton and Parker (2003). These arguments coinsides with Chambers and Pettit (2004) arguing for a bottom up approach.

In the following subchapter, the global strategy, coordinated and implemented by the Joint United Nations program on HIV/AIDS (UNAIDS) will be briefly described in order to understand how the top-down approach, in this case, were designed.


The global response to HIV/AIDS prevention

The AIDs Timeline 1981-2006, (Appendix D), illustrates the initiation and the development of the different global strategies to fight HIV/AIDS starting in 2001 with the Doha agreement on medication. In 2002, the Global fund was initiated, later followed by the President’s Emergency Plan for AIDS Relief (PEPFAR) under the United States Agency for International Development (USAID) in 2003. The global emphasis on medical treatment (Anti Retrovirus Treatment (ARVs)) during this period is clear, as there was nothing mentioned in the timeline of universal access to information or HIV/AIDS prevention, the other overall USAID objective.

The various sectors responded differently to the fight against HIV/AIDS but overall the health sector has been the dominant actor. The health sector led and coordinated a number of initiatives and interventions that garnered support from International Agencies, NGOs, Community Based Organizations (CBOs), Faith Based Organizations (FBOs), and other local and international actors. It is notable throughout that the active involvement of the education sector lagged behind (Baxten & Breidlid, 2009, Putzel, 2004).

Fighting HIV/AIDS on the global level reflects the dilemmas faced in development aid in general. The strategies as outlined in the UNAIDS program focused primarily on treatments thereby keeping the HIV/AIDS ball in the health sector’s court. Since its inception, the UNAIDS program has had an extensive expansion. In 2010, for example, HIV prevention education invest-ments were only about 22 percent of all AIDS spending in 106 low and middle-income countries (UNESCO, 2009).

The World Bank, UNAIDS, and bilateral donors all seemed to share the same interpretation of what a successful national HIV/AIDS program had in common, i.e., laying out “what works” based upon “best practice”. As far as Africa was concerned, the Bank referred mainly to the experiences of Uganda and Senegal and tended to apply this approach globally, as a blueprint, instead of going deeper into the various country contexts (Putzel, 2004, p.1131).

The “eligibility requirements” for the countries applying for funds within the Adaptable Lending Programme (ALP) introduced by the Bank (World Bank, 2000b, p. 13–14, in Putzel, 2004, p.1131) set the conditions for what later turned into The Global Fund thereafter into a Global Action Plan for fighting HIV/AIDS. The Global Action Plan coordinated and monitored globally by UNAIDS incorporated the Bank’s conditions, with modifications to incorporate the principles of multi-sectoralism, participation, decentralization and public-private partnerships (Putzel, 2004). UNAIDS applied what was called the “The Three Ones” to its programming.


Countries eligible for funding were required to have: � One national HIV/AIDS Action Framework � One national AIDS coordination authority, National AIDS

Commission (NAC) � One agreed country-level monitoring and evaluation system

For countries to receive resources from the Global Fund, the proposals had to be submitted and administered by a Country Coordinating Mechanism, broadly representative of national stakeholders, in Zambia called National Aids Commission (NAC).

The national coordinating bodies needed to be gender balanced and include actors from the academic and educational sector, government, NGOs and CBOs, people living with HIV/AIDS, TB and Malaria, the private sector, FBOs, and multilateral and bilateral development partners based in the country. The funding procedures were based upon a principle of ‘channeling grant funds for HIV/AIDS activities directly to communities, civil society and the private sector’ to support and fund multiple implementation agencies, through applications from the grassroots level, including non-governmental organizations (Putzel 2004). The application guidelines also required a comprehensive set of data, including strategies to address human rights and reduce stigma and discrimination (Putzel, 2004, p.1132). These procedures were far too complex for grassroots movements to access.

A number of critiques of the Global Plans emerged soon after they were launched. Klees (2008) argued that the conditions, also termed the ‘eligibility requirements’ ensured that funds channeled through one national high-level coordinating HIV/AIDS council effectively ensured that little support would reach the multiple sectors, and worse, still made it unlikely that effective support would reach communities, because of the bureaucratic hurdles of such a centralized approach, (ibid.). His views were supported by Oxfam (2004) that argued that complex and challenging approaches in most developing countries hardest hit by HIV/AIDS, would hamper the implementation of such ambitious programs. The countries hit hardest were challenged by a lack of qualified personnel, e.g. human capacity, and scarce financial resources.

Another initiative having a great impact on the global strategies was The Presidential Emergency Plan for AIDS Relief (PEPFAR) launched by United States President George W. Bush in early 2003, with its own set of conditions. PEPFAR’s approach focused on treatment and Abstinence (A) and Be faithful (B) approach. In spite of the fact that A-B-C (Condomize) approach was globally applied and mainstreamed in most prevention programs, including Zambia, the C was left out of the strategy due to pressure from the religious right in the United States. In other words, in order to access money from PEPFAR, the projects or programs applying for funding through PEPFAR had to revise their approaches and leave out the C, the promotion of condom use as a means of protection


against infection from the virus. A column by Dr. Phiri criticized the new PEPFAR approach the approach for not meeting the needs of Zambia:

This huge pool of funding [referring to USAID PEPFAR], initiated to fight the HIV/AIDS epidemic globally, is actually restricting its funds to those programs and organisations excluding the use of condoms as an effective HIV/AIDS prevention strategy. This exemplifies how decisions being taken far from the actual level where the disease flourishes, and [where] preventive actions are to occur, without any considerations of the effect upon those facing this threat in their everyday life. ….. The point being made....is whether it is ethically correct to deemphasise condoms in these programmes only because the religious right wing in US does not favour the use of condoms as an HIV prevention measure. Is it right for them to sit back and watch the great gains already made by countries like Uganda, using the combined ABC approach, slip (Dr. Phiri, Zambian Post, 04.05.2006).

This shift directly impacted the support to HIV/AIDS prevention at the country level. International and local NGOs working with HIV/AIDS prevention in Zambia had to re-tool their programs to leave out condomize (C), even though sensitization on condom use as a prevention strategy was part of the Zambian national strategy for HIV/AIDS prevention.

An analysis of the UNGASS HIV/AIDS indicators provides further evidence of the mismatch between global plans and local needs. From the NAC statistics (2010) it is evident that the health dimension of the disease takes priority over education. Out of 18 indicators, 10 are related to Anti Retroviral treatment (ARVs), HIV tests or other health related indicators. One of the indicators focuses on condom use, and two on the number of sexual partners. One may argue that condom use correlates with knowledge level, but the link between knowledge and behavioral change has been contested (Baxen & Breidlid, 2009). Considering the cultural and traditional norms and views regarding condom use in Zambia, the general silence and taboos related to openly discussing sex, and the subordinate role of women, (see specifically chapter 4) these indicators may not reflect the national needs, goals and objectives of the Zambia HIV/AIDs prevention and care programs.

The global indicators represented through the UN monitoring guidelines and requirements put pressure on the member countries to adopt the required indicators in order to be eligible for funding. As many of the drivers of HIV/AIDS in Zambia are socio-economic and cultural in nature, one would expect more attention being paid towards monitoring changes in this aspect of the HIV/AIDS landscape. Yet, it should be a key concern for UNGASS to address and emphasize the contextual and diversified landscape reflected in culture, traditions and sexual behavior. It might therefore be questioned whether a global monitoring scheme is the most efficient and relevant tool of addressing the development within HIV/AIDS prevention and care at the national level.


The success or failure of countries fighting the epidemic are measured and compared based upon these global monitoring and evaluation tools and statistics. Country needs and priorities may be in stark contrast to what UNGASS is monitoring.

To illustrate the lack of relevance and sensitivity to national contexts in the UNAIDS reports a simple search for words such as “traditions”, “traditional practices” “culture”, “cultural”, “polygamy”, “dry sex” in The Global Report (UNAIDS, 2010) were conducted, but the results came up short. The search resulted in only one hit. The word “Cultural” came up once, but then it appeared in the bibliography. This outcome coincides with similar searches related to global HIV/AIDS overviews from UNAIDS. Cultural and national discourses, particularly as they relate to the drivers of the HIV/AIDS epidemic, have been alarmingly absent from these global reports.

This study was conducted from 2002 to 2008. I was assigned as an external educational expert in Zambia by MOE to support them in implementing the existing HIV/AIDS education prevention strategy in one province piloting BESSIP. I was a member of the core implementation team in Southern Province, comprising staff from the provincial education office (PEO), a head teacher and District Education Board Secretary (DEBS). As the only external partrner, I spent numbers of weeks every year from 2002-2006 with the team. I took part in all the various activities comprising the whole HIV/AIDS prevention intervention strategy. From the mapping of the on-going HIV/AIDS prevention activities in the pilot district, to the development of the strategy and the actual implementation of the activities, within the new intervention, termed ISACA. We jointly developed and run the monitoring and evaluation procedures including long days and hours on the road, when visiting the District Education Offices (DEO) in the province, several schools in each district, as well as conducting meetings with relevant stakeholders involved in ours as well as parallel HIV/AIDS prevention activities.

The research site, the data, the observations and the respondents and informants were all from that same province, except for some few employees at MOE headquarter. The documents and data, the experiences and observations derives from the various activities related to the development and implement-tation of HIV/AIDS education prevention targeting the basic schools and their surrounding communities. In Chapter 4 further details about the development and implementation of the actual program, the research activities and my role in this intervention will be described.

1.5 Relevance of the study Zambia represents an interesting case study when exploring the challenges faced by different levels within the education sector when using schools as vehicles for HIV/AIDS prevention. Zambia was one of the hardest hit countries in Sub-


Sahara Africa (MOE, 2001a, 2002a, 2002b; UNAIDS 2006b, 2008) and at the same time, the country was one of the first countries in Sub-Saharan Africa that responded early to the epidemic by developing HIV/AIDS education policies and strategies (Global Campaign for Education, (GCE), 2005).

Out of 18 country studies conducted by GCE, Zambia was one of only two countries where MOE had developed policy and strategy for HIV/AIDS education prevention (GCE, 2005). Therefore, the study offers a unique opportunity to explore how HIV/AIDS education was implemented, the challenges and experiences over a period of 8 years. The study may have applicable lessons for other countries and external actors where the schools are assigned a specific role in transforming and support intervention aiming at solving or mitigating societal challenges in the region and possibly elsewhere, here implementing HIV/AIDS preventive strategies.

The study is directed at development practitioners and researchers occupied and interested in deriving in-depth information about the dynamics of developing and implementing localized developmental activities, illustrated here through the development and implementation of HIV/AIDS education prevention activities. The studyexplore how the educational structures, institu-tions and the educational leadership can play an important role in local adaptation and capacity building by actively going beyond the education sector, involving the broader learning environment in searching for appropriate HIV/AIDS mitigation strategies locally.

The outcomes of building upon national and local cultures, traditions and value systems through broad stakeholder involvement and participation, working across traditional boundaries, are therefore explored. Where actors from the formal education structure is working hand in hand with actors from the non-formal and informal environment and how that may generate new actions, strategies or objectives, beyond what previously were not thought of, the study aims at understanding the added value of broad partivipation through new relationships and social spaces. The Zambian HIV/AIDS educational strategy developed and how it was applied and implemented locally can be viewed as a step in that direction, and therefore offers opportunities for examining the conditions under which structural and cultural change within and outside the existing institutions and organizations can be made to work.

It is hoped that through the extensive fieldwork undertaken for this study, and through the analysis of the findings, the principles and lessons derived may be useful to Zambian stakeholders working in related areas, from MOE at national level to provincial, district, school and community level. It is also envisioned that the study’s lessons will be applicable elsewhere and thereby add new knowledge contributing to broader understanding of sustained, local development actions.

The study will hopefully contribute to an understanding of transformation processes in the education as well as other sectors, illustrating that cross-sectorial collaboration and adaptation to local contexts may lead to empowerment and


sustained transformative actions. These lessons may also apply to other developmental activities in any other fields aiming at behavioral and societal change in various aspects of human activity. This cross-diciplinery approach may also contribute to broaden or expand education as a discipline, including international and comparative studies as well as developmental work research.

1.6 Limitations of the study The present study is complex and holistic in its design and deals with a broad range of themes, each of which could be studied in its own right. But as previously explained, the multiple layers and perspectives are being selected in order to address the complexities of development aid, development and change, within a specific context; HIV/AIDS education prevention.

The qualitative and constructivist grounded theoretical approach brings out the voices of each stakeholder, e.g. those involved, consulted and responding during the project period. Their views and voices are interpreted through the lenses of the researcher, and consequently influenced by the researcher’s epistemological perspectives. The researcher, being a member of the project team, taking the responsibilities of the various project activities jointly with the core team members and also being a participant observer in other cases, the collegial relationship, internal discussions and reflections within the team contributed to a shared understanding of issues and challenges enhancing the validity of the data and research findings.

The fact that the researcher did not speak the local language may have affected the research outcomes. But the fact that the core team also shared the responsibility of running workshops and monitoring activities, when needed, expressions and words were translated and discussed among the team members. E.g. some Zambian concepts used during the discussions reflected a discrimina-tory undertone, these instances were brought up and clarified, and practical issues related to the Zambian protocols of behaving were applied where appropriate. These and in similar instances, team members facilitated the researcher’s understandings of the processes as well as the cultural impact of discussions related to sexuality and transmission of HIV/AIDS.

Issues of hegemony, or the possible impacts of hierarchical power dimensions (white Westerner-Northerner v.s. black African-Southerners) hindering an open dialogue and information sharing could of course be an issue. But through long-term collagoration, carefully adhering to local protocols, principles of involvement, local decision-making procedures and during a long-term project intervention process, issues of ownership and trust were gradually built up which in turn created transparency, credibility and accountability between the partners within the core the team and those we met frequently throughout the project period.


The selection of schools for the pilot phase of the program, and those visited as the project scaled up until finally comprising the whole province was carried out by the core coordination team members. They identified schools that could easily be visited and monitored as well as remote schools more difficult to access. This allowed for the inclusion of both resource-poor and isolated schools as well as those schools located in close proximity to information and resources. The inclusion of remote schools presented challenges to monitoring, as weather and road conditions made travel to these schools difficult and at times impossible.

The findings and discussions reflect the contextual realities of the HIV/AIDS discourse during the course of the program development and implementation, from 2002 to 2008. Due to the wide range and number of actors involved in HIV/AIDS prevention education in the province, it is impossible to attribute specific changes and attitudes identified in this study with particular interventions. However, the presence of a wide range of interventions and their possible impacts are noted.

1.7 Structure of the thesis This chapter has introduced the study and provided important background knowledge. Chapter Two gives an analysis of the socio-political and economic context, the prevalence of and impacts of the epidemic, as well as an overview of the Zambian education policy related to HIV/AIDS education strategy.

The next two chapters elaborate on and explain the theoretical and methodological issues and concepts. Chapter Three provides the theoretical framework used in the study and shows how the key concepts are linked and used to answer the research questions. The research methodology is then provided in Chapter Four. Chapter Five provides a literature review of the drivers of the HIV/AIDS epidemic in Zambia and the conditions putting people at the risk of contracting HIV/AIDS. Chapter Six is a review of historical and traditional role of the chief, or local eladers in Zambia, the structures of the chiefdoms, as well as their agency in HIV/AIDS prevention and local transformation.

Chapter Seven, Eight and Nine and respond to the research questions, focusing on the findings and analyses. Chapter Seven starts with the mapping and analysis of the ongoing HIV/AIDS education prevention under study during the inception, and further explores how the key stakeholders perceived and experienced the implementation of ongoing mitigating strategies locally. The multivoiced nature of the planning process for the localized HIV/AIDS interventions is described and analyzed in Chapter Eigh, and Chapter Nine explores the outcomes of the project particularly as they relate to change and transformation as brought about by the nexus of the HIV/AIDS education program with the traditional roles of the chiefs.


Finally, Chapter Ten reflects upon the findings in relation to the multivoiced and interactive approach used during the project period in order to address how power and local cultural artifacts actually contribute to change. The chapter also explores how this type of study, the tools and theories used can guide, and possibly benefit local development activities in other contexts.

1.8 Summary This chapter provided a background to the study, simplifying some of the discourses, critics of existing development approaches arguing that the strategies applied during the last decades have failed as they have adapted a global blueprint approach with a limited consideration of the national and local level conditions. It further lays out the research theme, its aims, objectives and relevance and some of the dilemmas policy makers and implementers face, as reflected in the global and local oriented discourses, as well as exploring the study’s limitations.

Since the mid 1980’s HIV/AIDS has been a global concern. The social, economic and developmental impact of the epidemic in Sub-Sahara African countries has been severe. In the following chapter, the Zambian context, including the educational statistics and structure, the impact of the epidemic and the HIV/AIDS education prevention strategies will be described.

Chapter 2

The Context of the Study

This chapter provides a brief history of Zambia and the geographic, demographic and socio-economic context. Further, the chapter addresses the prevalence of HIV/AIDS, characteristics and impacts of the pandemic. Finally, it gives an overview of the education system, its history and structure, characteristics and data relevant to the study objectives, including the HIV/AIDS education policies and strategies.

2.1 Contextual background In January 1964, Zambia gained its independence from Britain. In the first post-independence election, the United National Independence Party (UNIP) emerged as the majority party with Kenneth Kaunda elected as the first president of the Republic of Zambia. The country became a member of the Commonwealth on 24 October 1964 (Common Wealth Secretariat (CS), 2008). In 1991, after 27 years of one party rule under UNIP, Frederick Chiluba was elected peacefully which led to a multi-party democracy. After Chiluba’s ousting in 2002, successive democratically elected governments have been in place (ibid.). Levi Mwanawasa followed as the next president, and when he died in 2008, Rupiah Banda was the next successor.

Geography and demography

Zambia is a landlocked country in Sub-Sahara Africa, (see Figure 2.1) sharing boundaries with Malawi, Mozambique, Zimbabwe, Botswana, Namibia, Angola, Democratic Republic of Congo and Tanzania. The country covers a land area of 752,612 square kilometers (Infoplease, 2008). See Map of Zambia.

Administratively, the country is divided into nine provinces, namely Central, Copperbelt, Eastern, Luapula, Lusaka, Northern, North Western, Southern and Western. The provinces are further divided into 72 districts. This


study focuses on the Southern Province, situated along the main international trade routes towards Southern Africa, in the South-East corner of Zambia. The province is divided into eleven districts, namely: Choma, Gwembe, Itezhi-Tezhi, Kalomo, Kazungula, Livingstone, Mazabuka, Monze, Namwala, Siavonga and Sinazongwe (Save the Children, 2006). Topographically, Southern Province is divided into four areas, which are the valley, plateau, escarpment and Kafue flats. There are four main rivers, the Zambezi, Kafue, Kalomo and Ngwezi. Southern Province boasts of many tourists’ attractions, the major one being the Victoria Falls, located close to the province center, Livingstone (CS 2008).

Population, ethnicity, language and religion

After independence in 1964, when about 20 percent of the people lived in urban areas urbanization in Zambia increased steadily to 29 percent in 1969 and reaching 42 percent in 1990. Estimates from 2007, show a slightly different picture, 36 percent lived in urban areas and 13 percent in urban agglomerations of more than 1 million people (CS 2008). The population in 2007 was according to Ministry of Health (in CS 2008, p. ii) slightly above 12 million inhabitants. Statistics from Save the Children (2006) revealed that Southern Province’s population stood at 1.2 million in 2003/04 where, opposed to the general picture, only 21 percent of the population were urbanized. The population is relatively young; 47.6 percent are below 15 years old. There are 73 indigenous ethnic groups in the country. The largest one, representing about 18 percent of the population, is the Bemba of the northeast and Copperbelt province. Others include the Tonga of Southern Province, the Nyanja of Eastern Province and Lusaka, and the Lozi of the west. Officially, 78 languages are being spoken throughout the country, whereby English is the official language, and is widely spoken.

The country has successfully implemented seven written African languages used as optional languages of instruction in schools for the first three years based upon regional differences. The languages used are Bemba, Kaonda, Lozi, Lunda, Luvale, Nyanja or Tonga. In following years, English is the language of instruct-tion in basic education. Tonga is the majority language in Southern Province, but in Livingstone district 26 percent of the people speak Nyanja and 23.6 percent speak Lozi and Toka Leya. Livingstone also differs from the other districts, as not all people living there are indigenous to the district. This multilingual and multicultural context is further strengthened through tourism.

Most Zambians are Christians (50–75 percent), with traditional African beliefs being incorporated into their faith. Officially, there are minorities of Muslims and Hindus, amounting to about 24–49 percent, and approximately 1 percent of the population are considered indigenous believers (CS, 2008). Ngara


alone, around 40 percent of central government expenditures were financed through foreign grants and loans (ibid., 2004a).

Zambia reached the United Nations Department of Economic and Social Affairs status in 2005 resulting in about USD 7 billion in debt being cancelled through Highly Indebted Poor Countries’ (HIPC) program, according to the World Bank (http://data.worldbank.org/data-catalog/at-a-glance-table).

Poverty and urban-rural disparities In 1998, an estimated 73 percent of the population lived below the official poverty line compared to 70 percent in the early nineties (WB 2004a). According to UNHDR (2007), still 68 percent lived under the national poverty line, and 64 percent below one USD a day. Approximately 87 percent of the people in Zambia lived on less than two dollars a day making Zambia one of the poorest countries in the world (NASF 2010). Poverty is more prevalent in rural than urban areas, 80 percent and 34 percent, respectively (ibid.). Zambia Human Development Index (HDI) ranked 165 out of 173 countries covered by the 2007 United Nations Human Development Report (UNHDR), compared to number 163 in 2003. In 2010, the country was ranked 150 out of 169 countries in the Human Development Index (HDI) (UNDP, 2010).

The welfare state they once relied on failed as the civil service was ineffective in providing the goods and services normally expected of a government to deliver, e.g. education, health, and general administration that had largely disappeared as a public good (WB 2004a). The poor lack not only income but also access to basic services such as education, health services, safe water, and infrastructure.

Some basic statistics about living conditions in Zambia at the inception of the HIV/AIDS prevention education piloted in Southern province under Basic Education Sub-Sector Investment Program (BESSIP), scrutinized in this research may shed light on their contextual realities:

� 46 percent of the population were undernourished, (UNHDR, 2007); � 71 percent or 4.23 million children under 18 years lived in poverty in

Zambia (2002/03), worst in rural areas (UNHDR, 2007); � 55 percent of rural households and 85 percent of urban households

had access to safe drinking water (2002/03) (UNICEF, 2006); � 1 percent of rural households and 41 percent of urban households had

access to proper toilet facilities (2002/03) (UNICEF, 2006); � 12 percent of the population had access to electricity (The Post, 2008,

Nov.24), which is in accordance to findings from UNHDR (2007) stating that 9.5 million did not have access to electricity.

The disparities between the rich and the poor in Zambia illustrate large inequalities in distribution of income and consumption. The poorest 20 percent consumed 3.5 percent of national consumer goods and services while the richest

The Context of the Study 27

20 percent were responsible for 55 percent1. Zambia had reduced the rate of extreme poverty from 58 percent in 1991 to 43 percent in 2010 according to UNDP2. Extreme poverty continued to be higher in rural areas, e.g. 57 percent compared to 13 in urban areas.

In Southern Province, findings from Save the Children’s study (2006, p.13) underscored this diversity, revealing that:

� 85 percent of rural households compared to 19 percent of urban households lived in poor and overcrowded conditions (more than 5 people per room with a mud floor);

� 92 percent of rural households compared to 5 percent of urban house-holds had no access to either radio, telephone, newspaper or TV;

� 32 percent of the youth in rural areas were illiterate compared to 11 of their urban counterparts (2006, p.13).

The rural households therefore lacked strong sources of information. For about 80 percent of the population in Southern Province, the formal education played the most important role regards dissemination of information. This also includes knowledge related to HIV/AIDS prevention and mitigation.

2.2 HIV and AIDS in Zambia

HIV/AIDS prevalence Zambia reported its first HIV infection case in 1984. Since then, infection rates have increased rapidly with the adult HIV prevalence peaking in the mid-1990s at about 16 percent and then leveling off. Zambia had one of the world’s most devastating HIV and AIDS epidemics, being among the five countries having the largest epidemic in Sub-Sahara (Zambia Country Progress Report, United Nations General Assembly Special Session (UNGASS), 2010), but Zambia was among the countries in Sub Saharan Africa with the smallest decrease in HIV prevalence between 2001 and 2007. In 2009, 14.3 percent of Zambia’s, 12 million people, were infected with HIV whereas in 2011 the overall HIV prevalence was 13 percent. However considerably higher rates have been reported in some urban areas (http://www.avert.org/hiv-aids-zambia.htm). The. HIV prevalence in Zambia has been fairly stable over the last 15 years (UNGASS, 2010). In 2010, there were approximately 115 new infections each day, and more than one in every seven adults in the country were living with HIV.

1 See: http://hdrstats.undp.org/countries/data_sheets/cty_ds_ZMB.html 2 See: http://www.undp.org/content/undp/en/home/ourperspective/

ourperspectivearticles/2013/02/04/world-we-want-post-2015-campaign-takes-off-in-zambia.html


Statistics from the UN Global Report (2010) revealed that the total number of infected with HIV went from an estimated 830,000 in 2001 to 980,000 in 2009. Out of this number, approximately 860,000 (of the total population of approximately 12 million) were above 15 years of age, representing the most productive labor force. Table 2.1 indicates the estimated infection rate over the project intervention period.

The actual figures are difficult to estimate, which is illustrated in Table 2.1. The National profile from Ministry of health (MOH) and the national Aids Council, NAC (MOH, NAC, 2008, p. iv) also indicated that the overall adult HIV prevalence rate had gone down from 13.9 percent to 13.1 percent between 2005 and 2007, a reduction of 0.8 percent. But at the same time the number of infected had increased, from approximately 1,200 000 to 1,482,228 which is reflected in an increase in the total population. The increase in deaths due to AIDS during that period went from 95,373 to 97,494, confirming that the country still had a serious epidemic. The number of orphans also showed an increase of 10.8 percent, going from 1,197,867 to 1,291,079. More details on the epidemic can be found in Appendix A.

Table 2.1 Estimates of HIV infections in Zambia 2001 to 2009

2001 Adults + Children

2009 Adults + Children

2009 Adults 15+

2005* % of total population

2008* % of total population

Estimate [low – high]



1,8 million 1,7 million

830 000 [750 000 – 900 000]

980 000 [890 000 – 1100 000]

860 000 [800 000 – 940 000]

15,3 (Out of 12 mill)

14,6 (Out of 12 mill)

Source: Global Report, (2010, p.182), (UNGASS*, 2010, p. xviii). (www.avert.org.) HIV prevalence also varied a lot by districts and communities, with large disparities between urban and rural areas as shown in Figure 2.1. The geographical disparities showed that the HIV prevalence of urban adults was 19.7 percent, nearly twice that of those in rural areas at 10.3 percent. There were significant differences in HIV prevalence reported by provinces ranging from 6.8 percent in Northern (mostly rural) to 20.8 percent in Lusaka province (mostly urban). Three of the nine Zambian provinces had an increase in the HIV prevalence between 2001 and 2007: Central province increased from 15.3 percent to 17.5 percent. Western province increased by 2.1 percent from 13.1 percent to 15.2 percent and Eastern province increased by 2 percent from 11.2 percent to 13.2 percent (UNGASS, 2010, p. i). There were a total of six provinces, though, that showed a reduction in HIV/AIDS prevalence, where Southern Province


reported a decline from 17.6 to 14.5 during the period from 2001-2007, with the highest reduction of 3.1 percent (UNGASS, 2010, p. i).

Save the Children (2006) revealed the HIV/AIDS infection rates, projections and estimates of HIV/AIDS prevalence in Southern Province and districts from 1985 to 2010, see Table 2.2. The bold column represents 2002, the year of the program inception.

Table 2.2 Southern province estimated HIV prevalence by district from 1985-2010

District 1985 1990 1995 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 S/Province 6.5 13.7 18.0 17.7 17.6 17.2 16.7 16.2 15.7 15.2 14.7 14.3 13.8 13.3 Choma 7.7 16.3 21.3 21.0 20.9 20.4 19.8 19.2 18.7 18.1 17.5 16.9 16.3 15.7 Gwembe 3.0 6.4 8.4 8.2 8.2 8.0 7.7 7.5 7.3 7.1 16.8 6.6 6.4 6.2 Itezhi-Tezhi 3.0 6.4 8.4 8.2 8.2 8.0 7.7 7.5 7.3 7.1 6.8 6.6 6.4 6.2 Kalomo 7.5 15.7 20.6 20.3 20.2 19.7 19.1 18.6 18.0 17.5 16.9 16.3 15.8 15.2 Kazungula 7.5 15.7 20.6 20.3 20.2 19.7 19.1 18.6 18.0 17.5 16.9 16.3 15.8 15.2 Livingstone 12.4 26.2 34.3 33.8 33.7 32.7 31.8 30.9 30.0 29.1 28.1 27.2 26.2 25.3 Mazabuka 9.0 19.1 25.0 24.6 24.5 23.8 23.1 22.5 21.8 21.1 20.5 19.8 19.1 18.4 Monze 7.7 16.3 21.3 21.0 20.9 20.4 19.8 19.2 18.7 18.1 17.5 16.9 16.3 15.7 Namwala 3.0 6.4 8.4 8.2 8.2 8.0 7.7 7.5 7.3 7.1 6.8 6.6 6.4 6.2 Siavonga 7.7 16.3 21.3 21.0 20.9 20.4 19.8 19.2 18.7 18.1 17.5 16.9 16.3 15.7 Sinazongwe 3.0 6.4 8.4 8.2 8.2 8.0 7.7 7.5 7.3 7.1 6.8 6.6 6.4 6.2 Source: CSO HIV/AIDS Epidemiological Projections (Save the Children, 2006, p.14).

The table shows a great variation in the prevalence between the 11 districts, where the urban and semi-urban areas are worst hit by the epidemic and Livingstone was the district with the highest HIV prevalence, 32.7 percent, opposed to e.g. Gwembe and Itezhi-Tezhi, being fairly remote and difficult to access, both having a prevalence of 8 percent. The overall HIV prevalence in the province as such was at 17.6 percent, but the gender-segregated statistics showed that the women were more vulnerable, having an overall infection rate at 20.2 percent opposed to 14.6 percent among their male counterparts.

Annual HIV/AIDS incidence

In order to control the HIV epidemic, including distribution of the new infections by risk groups (UNAIDS, 2004, 2007) one needs to understand where new infections are coming from. In spite of that, in Zambia more studies have been conducted on the HIV prevalence (percent of a population with the virus) than on HIV incidence. If the incidence is known, the temporal changes in the epidemic can be better identified, characterized, and linked to specific risk behaviors over the same time (UNGASS, 2010, p. 32).


HIV incidences in Zambia, according to Central Statistics Office (2008 in UNGASS, 2010, p. 32) were consistently higher in women than in men. Since 1997 until 2009, it was estimated that the annual incidences were about 2 percent in women and about 1.2 percent in men, the overall figure can be seen in Appendix B.

The relationship between the timing of various HIV prevention initiatives and HIV incidences in Zambia also reflect that the health sector activities, e.g. including blood screening, and the introduction of medical care, testing and introducing Anti Retroviral Treatment (ARV) has been the main global response to the epidemic. All initiatives, except for the distribution of condoms, has been health related as identified by UNGASS (2010). This further underscores the overall absence of a broad global prevention education initiative. The only major shift in reducing the number of new incidents came after the introduction and social marketing of the condom, as well as the condom distribution. That made a significant shift, but since 1996-97 until 2010, the overall incidence rate has been the same, around 2 peercent.

HIV/AIDS information and education level

In 2008, the ZDHS (2008) showed that about 3 out of 4 people between the ages of 15 and 49 knew that consistent use of condoms was a means of preventing the spread of HIV (73 percent for women and 74 percent for men). Ninety percent also knew that limiting sexual intercourse to one faithful and uninfected partner could reduce the chances of contracting HIV; and eighty-five percent knew that abstaining from sexual intercourse could reduce the chance of being infected with HIV (ibid. p.23). The study further noted that among those with lower education levels corresponded positively with lower knowledge levels of HIV and its transmission.

In 2008, the National Aids Commission (NAC) looked specifically at the knowledge, skills and attitudes of the 15-24 age group regarding HIV/AIDS. The Commission found that the percentage of young people aged 15-24 who both correctly identified ways of preventing the sexual transmission of HIV/AIDS, and also rejected major misconceptions about HIV transmission, were approximately 34 percent for women and 37 percent for men. (NAC, 2010, p. iii). In contrast to the ZDHS age category of 15-49 year olds, the subset of younger people in the NAC study were less knowledgeable about how to protect themselves from HIV.

The Ministry of Health (NAC, 2008, p.iv) subsequently advocated for increased attention to the approximately 4.2 million school going children and youths between 6 and 14 years old for HIV/AIDS prevention interventions. Youth below 15 years of age, they argued, are more ‘reachable’ by HIV/AIDS education and therefore programs should focus on reaching out to that demographic group. The youth below 15 years represent the 4.2 million school


going children from grade 1-12, who could be reached through HIV/AIDS prevention education.

2.3 Impacts of HIV and AIDS

Life expectancy and mortality

HIV and AIDS are reversing many of the developmental gains Zambia would have achieved, had the disease not been rampant in the country. The life expectancy rate at independence in 1964 was 46 years1 and increased to about 51 in the 1979. See Table 2.3.

Table 2.3 Life expectancy at birth by year

Year 1964 1979 1989 1999 2009 2012

Life expectancy at birth 46 51 45 41 53 57

Source: http://countryeconomy.com/demography/life-expectancy/zambia The HIV/AIDS pandemic severely affected Zambian life expectancy. As can be seen from Table 2.3, average life expectancy at birth increased from independence and peaked in 1979. The first HIV/AIDS infected person in Zambia was identified in 1989, and we can see the reduction in life expectancy, continuing until 1999, before a slow increase towards 2009, reaching the levels of 1979. During the last few years, the rate has had a steady increase until 2012. The child and infant mortality rate that had shown a decline from 1996 to 2002 (109 deaths/ 1000 vs. 95 deaths/1000) is now rising. According to UNICEF (2013)2 the Infant Mortality Rates in Zambia, in 2012 were still between 85 deaths/1000 and 110 deaths/1000.

The impact of the loss of health workers and teachers from death, sickness or caring for others due to AIDS, threatens the foundation for future growth, as the health status of the country further eroded and children left school not adequately prepared to play their future developmental roles (ibid.).

Socio-economic impacts HIV/AIDS has been devastating for households as well as the agricultural labor force, as both affected individuals and non-affected family members often stop working (UNAIDS, 2006). According to Kelly (2004) the impacts of HIV/AIDS can be seen in increased poverty, slower economic growth, depletion of skills and

1 http://countryeconomy.com/demography/life-expectancy/zambia 2 http://en.wikipedia.org/wiki/Infant_mortality


social capital, chronic food insecurity, overstretched health systems, debilitated education systems, single parent households, female-headed and child-headed households, growth of orphans and vulnerable children (OVC), increased burdens on elderly, human rights problems and growing management and governance problems. HIV /AIDS undermines Zambia’s ability to provide decent standards of living for the citizenry. Although the economic impact of HIV and AIDS has not been modelled for Zambia, other countries that have carried out this exercise have found that the impact of HIV and AIDS would reduce gross domestic product (GDP) by as much as 1 percent. If this were to hold for Zambia, it would be a huge economic reversal for the country.

The performance of agriculture, considered as a mainstay of economic development, is similarly under threat. HIV and AIDS-affected households are reducing their cultivation areas as they face serious labor constraints related to death, care of chronically ill family members, and attending funerals. Yields are falling because the most productive farmers are dying. Many extension workers who are expected to train farmers are also dying or are too sick to work effectively. Farming households are too labor-constrained to manage their farmsteads properly and they may not afford the cost of fertilizers or improved seeds because they have to spend money on medicines and burying their dead. Over time, farming households are reverting to subsistence agriculture and in most cases, cannot secure full household food security.

Orphans and vulnerable children AIDS has led to an increase in the number of orphans and vulnerable children (OVC) in Zambia. The number of children orphaned by AIDS was projected to reach about 1.3 million in 2007 in Zambia, opposed to close to 600,000 without AIDS (UNDP, 2007). The operational definition of an OVC is

a child below the age 18 with one or both parents deceased. A vulnerable child is defined as a child below age 18 who has a chronically ill (sick for three or more consecutive months within the last 12 months) parent or who lives in a household where an adult has been chronically ill or has died (ZDHS, 2007 in Zambia Country Progress Report, UNGASS 2010, p 62).

In 2012, the number of orphans in Zambia due to HIV/AIDS was 1.3 million accounting for as much as 10 percent of the whole population1.

The social and economic costs of the increase in number of orphans have been enormous. For a country with no well-developed social security system, kinship relationships are the only safety nets that families in need may fall back on. The burgeoning numbers of children orphaned by AIDS who need support and care are overloading the caring capacity of Zambia’s traditional extended

1 See: http://countryeconomy.com/demography/life-expectancy/zambia


family system. The system has performed heroically given the scale of the problem. However, the emergence of child-headed households, where children as young as eight years old are taking on the role of heads of the family is alarming. Children providing care for other children seems to suggest that the extended family system has seriously eroded as the context within which is functioned and was regulated has changed due to the epidemic.

The fact that the HIV epidemic coincided with sharp rises in poverty meant that the system was already at its weakest position to take on this extra burden. Many of the children whose parents have died lack not only parental care and guidance, but also cultural, social and familial ties and life skills that are usually passed on from generation to generation. They are deprived of their childhood and many of them lose the opportunity to go to school. These children tend to be attracted to big cities and towns thereby increasing the number of street children. Economic hardships lead them to look for a means of survival (UNDP, 2007, p. 4) which often increases their vulnerability to HIV infection. These include substance abuse, child labor, prostitution and delinquent behavior.

The number of OVCs and the ramifications is what Kelly (2010) called the third wave of the epidemic. With such a huge number of children brought up under severe conditions, over stretched burdens for the extended families, an increasing number of grandparents substituting parental care, and the growth of OVCs and child headed households might lead to new challenges for future individual and societal developments in Zambia.

A twin problem of poverty and HIV/AIDS HIV and AIDS are making it much more difficult for Zambia to fight high levels of poverty. The disease and its impacts are undermining the capacity of households to accumulate or make adequate use of assets at their disposal in order to pursue viable livelihood strategies. Both the quality and quantity of human capital in households are diminishing due to deaths, illness or children dropping out of school because they are orphans or need to help in providing for the household. This negatively impact the foundation of households’ capacities to get beneficial livelihood outcomes and also reinforces the already widespread poverty.

Impact on schooling In Zambia the magnitude of the impact of HIV/AIDS on the education was recognized in the late 1990’s, when the numbers of teacher deaths, according to MOE began to rise steeply, from 2 per day in 1996 to more than four per day in 1998 (Das et al. 2005). Shocks due to illnesses and funerals lead to high absenteeism from school long absences and substantial declines in teaching performance in addition many also have to take care of sick family members. Teacher absenteeism creates additional work and overburdened workloads for


the remaining teachers, increasing the need for additional untrained contract teachers (Rasing, 2003; UNDP, 2003). In Zambia as in Sub-Saharan Africa in general, deaths and resignations due to HIV/AIDS constitute an important cause of teacher attrition.

In terms of absenteeism, the variation is striking. For instance, absence rates in US-based studies tells that 5 percents are low compared to those in low income countries where an ongoing study finds averages of 20 percent and above in Sub-Saharan Africa. In Zambia a study by Das (2005) revealed that the percentage of teachers absent from school at the time of a surprise visit were closer to 17 percent and average days of absence just under 21 days in a year.

A study on teachers and HIV/AIDS in Zambia conducted by Changes1 2 (2007) revealed that HIV and teachers rate of infection is a serious problem in Zambia. They further stated that accurate data on infection rates is problematic because of the social stigma attached to the disease and the risk of under reporting. Based on extrapolations from the most recent District Household Survey, the adult infection rate was estimated at 16 percent (World Bank (2006) p. 8 in Changes, 2007). The trend of infection rate is unclear, as there were no data on the infection rate among teachers. However, the first cycle of voluntary testing in 2005-6 found that 19 percent of those who volunteered for testing were positive, while early data from the later cycle of testing (2006-07) found 9 percent positive (ibid).

ART was initially made available free to MOE staff, financed by MOE. The uptake of this treatment seems to have risen rapidly. In 2004, there were 600 MOE staff reported to be obtaining Antiretroviral Treatment (ART) through the MOE (World Bank (2006) Zambia, Education Sector Public Expenditure Review, p. 8, in Changes2, 2007), but by 2005, one year later, this figure had risen to 2,500. In 2006, the government began to provide ART free to all citizens through government health clinics, and the MOE ceased its scheme. As a result, there has been no teacher-specific data since 2005. According to the Zambian Country report to UNGASS (2010) ART has expanded to most areas with more health facilities administering it, but the rural areas still lag behind as facilities in the rural areas are either lacking in qualified personnel and equipment, or not easily accessible due to the long distances.

Teacher mortality from all causes has been fluctuating between 1-2 percent of teachers annually. Overall teacher mortality has been rising. Deaths of teachers in basic education rose from 457 in 2002 to 872 in 2006 (Changes, 2007, p.13). However, HIV/AIDS is rarely recorded as the cause of death, due to taboos and stigma so no accurate data is available on teacher mortality from HIV, as can be seen in the Table 2.4.

1 Changes 2 is a USAID funded HIV/AIDS prevention program in selected districts,

including some district in Southern Province


Table 2.4 Deaths among teachers due to AIDS

Deaths Among Basic Education Teachers 2002-06 (EMIS 2006) 2002 2003 2004 2005 2006 Deaths 457 636 824 872

Percent of basic education teachers 1.1 1.5 1.8 1.7 Source: Changes 2, 2007, p.13.

Other estimates show that infected teachers are likely to be absent and unable to teach for a total of 260 days before dying of HIV/AIDS (UNDP 2003, UNESCO, 2006). This is a loss of more than one year of teaching time for learners. In addition to its impact on the supply of teachers, a major concern is the serious consequences for instructional time and as a consequence the student achievement.

Zambian country report to UNGASS (2010, p.93) identified the trends in school attendance rate between orphans and non-orphans from 2000 until 2009. The report revealed tha while there was an almost equal rate of school attendance for non-orphans and orphans in 2000, respectively 74.8 percent and 73.6 percent the non-orphans rate of school attendance increased to 82.9 percent in 2003 as compared to 76.3 percent for the orphans. According to MOE (2002, 2003) this was probably related to the national emphasis on universal access to basic education. At the peak in 2005, the rate of school attendance for both orphans and non-orphans was almost equal 92 and 90 percent respectively. MOE initiated bursary schemes for orphans, to support their schooling in 2003 that positively influenced attendance rates. As might be the reason for the figures in 2009, when it was noted that the rate of school attendance for orphans was higher (88 percent) than the non-orphans (81 percent).

The existing data does not indicate whether or not these declines were directly related to HIV/AIDS prevalence, which were symptomatic as stigma and taboos prevented people to reveal their status, as was also seen in the statistics on teacher absenteeism by Changes (2007). This lack of openness on HIV/AIDS is also confirmed by the Zambia Country Progress Report (UNGASS 2010, p. vx), which revealed that in 2010 only 15 percent of sexually active adults knew their HIV status.

The total number of orphans receiving bursaries was about ten times higher in 2007 than 2003, according to the overview given by UNDP (2010), the figures by year were: 8186 (2003), 13993 (2004), 68415 (2005), 94957 (2006) and 87009 (2007). The number of females outnumbered the number of male orphans every year with approximately the same relative difference by 2.7 percent. This was also supported by the removal of school fees in 2002 and Free Basic Education and Re-entry Policies. Such policies also favored an increase of 29 percent access in primary school completion rates, from 64 in 1990 (MDGR) to 93.2 percent in 2009 (UNDP, 2010).


The presence of a sick (presenting symptoms of AIDS) household member, combined with social and economic inequalities, affects a child’s ability to attend school in multiple ways (Kelly, 2004). Many had to take care of sick family members, and subsequently could not attend school. Bullying and violence in schools due to the stigma surrounding the child where family or relatives were being infected, seriously affected pupils’ physical and mental health and the development of social and cognitive skills, often resulting in poor academic achievement are some of the negative impacts.

Sexual harassment of girls also often resulted in low self-esteem, poor levels of participation in learning activities, dropout and even suicide (from Vally, 2003, in UNESCO, 2008, p.86). It also lead to early and unwanted pregnancy and the spread of sexually transmitted diseases including HIV/AIDS, witch again directly affected school attendance (ibid.).

2.4 Overview of Zambian education history and policy

A brief overview of the historical roots of modern education in Zambia will give a better understanding of the existing structural and cultural managerial strategies. According to MOE (2005b), Western education can be traced back to the early missionary settlements around then Northern Rhodesia (now Zambia). The earliest among them were at Sefula, in Western Province in 1887 and the Paris Evangelical Mission, and Mbereshi in Luapula Province established by the London Missionary Society in 1900 (MOEZ, 2005b, p.3). The evolution of education policy in Zambia can thereafter be classified into three eras: the colonial era: 1924-1963; the period of the First and Second Republics: 1964-1991; and the current period starting in under a system of multi-party democracy (ibid.).

In the period 1924-1963, until independence in 1964, the education policies were based on the unequal provision of educational opportunities between indigenous Africans and white settlers. This was represented by a separate school policies for Africans and Europeans. African education was focused on ensuring the supply of labor for the colonial government, whereas the non-African education was to prepare the European children for the more developed, competitive and sophisticated society found in Europe. In spite of being a decentralized system, managed through Local Education Authorities, there was very little input, if any, from the local community.

After independence from British colonial rule through 1991, the main priority of the Zambian Government was to dismantle the racist system of education and replace it with a system that would provide equal opportunities for all regardless of race, tribe or religious affiliation.


The education policy was guided by three main principles:

� Equality of educational opportunities for all � Foster sense of nationhood and national unity without promoting

educational uniformity � Serve the needs for national development without frustrating the full

development of individual abilities and satisfactions (MOE, 2005b, p.4)

These three guiding principles were designed to provide system changes in: i) access to primary, secondary and higher education, ii) the nature of the curriculum, iii) retention of pupils in school, iv) financing of education, v) teacher supply and vi) ownership and management of schools (ibid.).

In order to realize these intentions, the Government created a highly centralized education management system. School fees were abolished and only statutory school funds were allowed. Due to a deteriorating economy, however, the need to involve parents in contributing to their children’s education resulted in the creation of Parent Teacher Associations (PTAs) in 1976. One of the roles of the PTAs was to mobilize funds for school supplies and special projects. In order to meet the challenges of improving access and quality, the first major education policy reform in 1977 was passed. It was based on the need to integrate study with work, “stressing equal balance between education and production” (ibid.). Due to economic constraints, however, the 1977 aims of the education reforms were not implemented and thus little of the envisioned systemic changes materialized.

The third period from 1991 and onwards was initiated with the shift that year to a multi-party political system. The enrolment and completion rates had increased since independence due to a rapidly increasing population; however, the provision of classroom space was unable to keep pace with increased demand for education. As classrooms became overcrowded, demand for education dropped. The new government’s education policy, Focus on Learning, stressed mobilization of resources for the development of education (MOE, 1996) followed by a second major national education policy, Educating Our Future, launched in 1996. The policy addressed issues of education delivery, reflecting the general environment of a liberalized economy and a democratized political governance system (Saasa, 2002, p.55). A guiding principle behind the reform process has been that provision of education at all levels through strong partnerships between the MOE, other government ministries, NGOs and communities (ibid., MOE, 1996). The overall education policy framework in Zambia, Educating Our Future, is “based on the principles of liberalisation, decentralisation, curriculum relevance and diversification, efficient and cost effective management, capacity building, cost sharing, partnerships, access, equity and quality education” (MOE, 2005, p.5), and is still the national policy framework.


Basic Education Sub-Sector Investment Program (BESSIP)

The policies and strategies guiding the principles stated in Educating Our Future, were further developed through Basic Education Subsector Investment Program (BESSIP). It was launched in 1999 and piloted in selected provinces, including Southern Province in 2001. As the HIV/AIDS education policy came out as an important component in this document, further strengthened in MOE’s Strategic Plan (2003-2007), the overall education strategy within these frameworks guided the HIV/AIDS intervention activities underscrutiny, and is therefore described in detail in the following. The broad objectives of BESSIP were to address poverty and gender inequality, according to Saasa (2002) and Musonda (2008) that aimed at:

� increase school enrolment and reduce disparities between rural and urban areas; and

� enhance the learning achievement of all pupils, taking into consideration the needs to eliminate gender inequalities (Saasa, 2002, p.55), through

� pedagogical reforms and managerial capacity building (Musonda, 2008).

Increased construction of schools, the removal of school fees, as suggested in 2002, the introduction of free basic education and new re-entry policies were also key elements of the new education framework1.

Implicit in BESSIP’s overall objective, was a government-emphasized partnership in educational provision. The key policy principles were liberalization, decentralization and cost sharing (Musonda, 2008; Saasa, 2002; WB, 2003). It applied an approach to decentralization where power were devolved from the center to local levels in districts and schools, and by strengthening the control and management of education at the local level, a broader participation in educational management, emphasizing creativity and innovative lower level educational management was expected (WB, 2004a). MOE’s (2002b) decentralization strategy also aimed at strengthening local institutions to facilitate more effective citizen participation in governance and more accountable delivery of public services.

The goals of the decentralized education delivery, according to MOE (2002b) were to: i) promote community participation in all matters related to national development, ii) enhance coordination of development efforts, and iii) alleviate poverty through the introduction of a localized syllabus with relevant practical life skills. The localized syllabus should account for 10 percent of the content. These three principles were of key importance for the HIV/AIDS strategy upon which this research is based.

The policy promoted a broad-based participation in the management of education, emphasizing the creativity, innovation and imagination of the local- 1 See: http://www.ntbc.co.zm/index.php?option=com_phocadownload&view

=category&download=232&id=26


level education managers (ibid.). This also included the establishment of Education Management Boards at province and district level as a part of the decentralization structure in service delivery.

MOE (2002b, 2005b) underscored that under this policy the district level should be the focal point for the planning and delivery of the educational services, coordinated and implementation in in close collaboration with the provincial level. They further stated that these goals could only be realized through a gradual process that involves a number of actions including:

� devolution of administrative and political authority to the district level; � integration of government agencies at the district, zone and ward levels

into one administrative unit, the local government; � moving the centre of implementation of plans from the central

government to districts; � assigning functions and responsibilities to the various levels of

government; and � promoting popular participation at all decision-making levels (MOE,

2005b, p.6).

This would, according to MOE (2007, p.10) ensure that the education sector policy was implemented within the overall national framework of government policy and programs and at the same time also align with the overall global markers of education development1.

Within the decentralized system, the National Ministry of Education continues to be responsible for policy analysis and development, strategic planning, resource mobilization and allocation, development of the national curriculum, quality assurance and standards, supervision, monitoring and evaluation, data collection and management, and the determination of overall personnel policies for the system (MOE, 2005, p.17).

There were nine Provincial Education Offices responsible for coordination, support and monitoring of education activities. The HIV/AIDS intervention at scrutiny in this research, was managed and coordinated by the provincial education office in Southern Province and implemented by the District Education Board (DEB). At the provincial, district and school levels the permanent secretary was represented by the provincial and district education officers (PEOs and DEOs) and principals respectively.

One important development of the decentralized system is that the district develops and prepares budgets according to its own activities and needs, including the HIV/AIDS activities, before submitting it to the province level for

1 In 2003, the Strategic Plan 2003-2007 (MOE, 2002b) replaced BESSIP. The Strategic

Plan was in January 2008 again replaced by the National Implementation Framework (NIF) (MOE, 2007) replacing the Strategic Plan and this again signaled the end of the SWAPs.


further coordination and approval. This has strengthened the involvement and ownership of local actors to engage in the development and implementation of a localized approach opened up for a diverse strategies and solutions to HIV/AIDS education at district, school and community level.

2.5 Educational structure and enrollment Zambia’s education system during the time of the research period consisted of academic training at the primary, secondary, and tertiary levels. The formal system was in a transition moving from a 7-5-4 structure to a 9-3-4 structure (nine years of basic, three of high school and two to five years of college/university education up to first degree).

In the new system, there were nine years of basic education, with grades 1-7 considered lower basic, and grades 8-9 considered upper basic. This is followed by three years of high school education (see Figure 2.2). Not all basic education schools currently offer the upper basic grades, resulting in limited capacity in grade 8, and capacity control through the grade 7 completion examinations.

Lower basic Grades 1-7

Official entry age of 7. Grade 7 examination used for selection to grade 8.

Upper basic Grades 8-9 Grade 9 examination used for selection to grade 10. Historically these grades were taught in high schools. Under the current system, these grades are taught in most basic schools.

High school Grades 10-12 Grade 12 examination used for selection to higher education.

Figure 2.2 Structure of the educational system Source: Changes, 2007, p.3.

A more detailed education structure can be seen in Appendix C. Education is provided through over eight thousand schools, of which 63 percent were either government schools (GRZ), or granted-aided schools supported financially by the government. Almost a third of the schools are “community schools”. These schools were established by communities and initially financed by the communities. While these started to receive capitation grants from the state, they adhered to the national education framework, but became self-managing and financially dependent on their communities. These were, and still are, typically small low-cost schools often staffed by unqualified teachers.


Number and distribution of schools

According to the Education Management Information System (EMIS) (2006, in Changes 2007, p. 3) the number of schools by agency is illustrated in Table 2.5.

Table 2.5 Number of schools by agency

GRZ Grant Aid Private/Church Community Total Basic schools 4,243 462 355 2,575 7,635 High schools 377 69 88 6 540 Total 4,620 531 443 2,581 8,175 % of total 57 6 5 32 100

Source: Changes 2, 2007, p.3. There were a total of 4,243 basic governmental schools, and 2,575 community schools, a total of 7,635 when including the grant aided, private and church funded schools. According to MOE (2008, p.18) there was an increase in the number of schools in 2007, to a total of 8,013, those offering grades 1-9 were 2,498. However, there was a decline for the number of schools offering grades 1-12 and grades 10-12 respectively. This tendency reduces student access to higher education.

Out of a total of 8,013 schools, 1,231 were located in urban and 6,782 in rural areas, giving a total of 84.6 percent of the national schools located in the rural areas (MOE, 2008, p.24), including community schools (ibid., p.20). Considering the rainy seasons and lack of proper infrastructure, access to the many rural schools, were in periods difficult if at all possible. Management and support of the rural schools is also challenging due to the typography and seasonal climate change.

In Southern Province, there were a total of 121 basic schools, grade 1-9, 516 primary schools, grade 1-7, 204 Community schools and 3 teacher-training colleges. There were also 5,996 basic schoolteachers while 6,663 were required leaving a short fall of 667 (Save the Children, 2006, p.13).

2.6 Quality, access and completion Access refers to the extent to which education is being accessed by the general eligible population at a given education entrance level. In the Zambian case, access is predominantly at four levels, namely Grade 1 entrance, Grade 8 level, Grade 10 level and entrance into tertiary institutions at Grade 13. There are two main indicators that are used to determine access to education: Net Intake Rate (NIR) and Gross Intake Rate (GIR)1. A brief overview of the basic education

1 NIR is defined as new entrants in the first grade of basic education who are of the

official primary school-entrance age, expressed as a percentage of the population of


indicators based upon the baseline data for 2002, being the year of the HIV/AIDS program initial work-shop, and the development during the implementation phase and the MOE’s indicators is discussed in this section (2008, p.30).

At the national level, the GER increased from around 84 percent (males: 87.4 and females: 80.1) for grades 1-9 in 2002, to a total of almost 120 percent in 2008 (males: 123.4 and females: 115.6). The gender disparity gradually increased over the period from 2002-2008 regards GER, whereas with NER there were basically no gender differences, but shows a similar raise from a total of 74.8 percent (where 76.8 are male, and female accounts to72.7) in 2002, to 102.2 percent in in 2008 (102.7 male and 101.8-female)

The completion rates for the 1-7 cycle and the 1-9, t showed a rate at 64.3 percent (male: 70.5 and female: 58.2), and for 1-9 the same year, a completion rate at 35.3 percent, (male: 38.3 and female: 31.9). This had increased to 90.7 percent for 1-7 in 2008 (male: 96.9 and female: 84.4), and respectively 51.4 percent (male: 56.0 and female: 46.9) for the 1-9 cycle. The completion rate confirms the pattern where female students are lagging behind, and indicates an increasing gender disparity at the upper basic education levels. There is also a remarkable growth in the general completion rate in both categories of schools, where in 2008 approximately 90 percent completed the 1-7 cycle, but only approximately 50 percent completed the 1-9 as an average. However, the figures also indicate an inefficient education system where only about half of the students complete the 1-9 cycle.

Access and enrolment to Upper Basic Education, Grade 8-9, grew from 234,059 in 2004 to 451,163 in 2013 representing an increase of 93 percent. The number of students in grade 7/8 and 9/10 in 2005 to the estimated numbers in 2015 dropping out of school, or rather “pushed out”, as it is termed in the (Ministry of Education, Science, Vocational Training and Early Education (MESVTEE) 2014, p 19) is illustrated in Table 2.6.

Of particular concern according to MOE, is the fairly high dropout rate for girls, an average of 5 percent, as they know that quite a number of them are leaving school as a result of being pregnant or getting married (MOE 2008, p.28). A total of 3,960 girls dropped out of school in grades 8-9 as a result of pregnancy. The other reasons cited for dropping out of school in grades 8-9 included economic reasons and children being orphaned. For grades 10-12, a similar pattern was observed.

the same age, whereas GIR is defined as the total number of new entrants in the first grade of basic education, regardless of age, expressed as a percentage of the population at the official school-entrance age (Smith et al, 2003).


Southern Province shows that 56 percent of their population in the province were literate e.g. able to read and write with 61 percent of males and 51 of females able to read and write in any language (Save the Children, 2006). The rather rural Gwembe district had the lowest youth literacy rate followed by Siavonga and Sinazongwe Districts. They found that the youth literate rates are higher in the urban areas, e.g. in Livingstone and Monze.

2.7 HIV/AIDS education

Policies

Before the implementation phase of BESSIP (2001-2006) the planners agreed that the threat related to the spread of HIV/AIDS could make the attainment of the BESSIP goals difficult, if not impossible (MOE, 2001b). The implication of this was, according to (Zambia Country Progress Report – UNGASS 2010, p.59), that

Under BESSIP, MOE developed a comprehensive HIV and AIDS strategy, which will be scaled up. This strategy is at three levels: the mainstreaming of HIV and AIDS issues in the curriculum; dissemination of information to both learners and teachers; and the workplace program, which includes advocacy, and Antiretroviral Therapy (ART). The country has a policy/strategy promoting HIV-related reproductive and sexual health education for young people and HIV education is part of the curriculum in primary schools, secondary schools and teacher training institutions.

According to MOE, any interventions in this area should be implemented in line with the national HIV/AIDS strategies and educational framework1. Furthermore, MOE recognized its potential to effect positive change, stating that: “The ministry of education is in a comparatively advantageous position to influence behavior change, especially among the young children” (MOE, 2001, p. 1)

MOE (2002) acknowledged that AIDS is preventable. Therefore, MOE argued, the most important aspect of any education programs should be to include the mobilization of all sectors in the society, foster the openness to change, and the determination to break the silence about HIV/AIDS. They underscored strongly that “We know that education is a resilient social structure that can work on reducing HIV/AIDS and alleviating its impacts through

1 Zambia National Strategic Framework 2001-2003 (MOE 2000), BESSIP (MOE 2001a)

and the Ministry of Education Statement on HIV/AIDS, the HIV/AIDS Education Strategic Plan (MOE, 2001b).


teaching activities and life skills and prevention programmes with well trained and well supported teachers” (MOE, 2002, p. iv).

MOE supported the arguments raised by several researchers and organizations (Kelly, 2000, 2006, The Global Campaign for Education, 2005, UNESCO, 2008), addressing the importance of using the education sector in fighting the epidemic. The fact that the high illiteracy level fueled the epidemic, was acknowledged, stating that people needed skills to be able to translate knowledge into practice leading to sustained behavioral change (MOE, 2002, p.9), and also realizing that effective leadership and good management is critical for education institutions in order to implement the strategy. The HIV/AIDS pandemic, however, had thrust senior level responsibilities on lower level managers much earlier than expected and without sufficient support. Therefore, leadership development programs and teacher training strategies were required to strengthen managers’ ability to achieve results in these difficult situations.

The data was gathered between 2000 and 2008 and the main guiding policy frameworks and prevention strategies were guided by BESSIP (2001-2006) and Zambian National Strategic Framework (2001-2003). MOE’s HIV/AIDS Education Program’s main goal was to reduce the further spread of HIV/AIDS and mitigate the impact on those infected and affected by HIV/AIDS by enabling Zambia’s educational system to respond effectively to the pandemic. The key outcome was a strategic plan that focused on prevention messages, to ensure safe and supportive education institutions and learning environments that promote choices, positive behavior and attitude amongst learners, teachers and managers. The MOE institutions and structures should also demonstrate effective organizational capacity and performance to ensure expanded comprehensive response based on behavioral surveillance surveys, which provide reliable measures of HIV risk behaviors amongst learners, teachers and education managers (MOE, 2002c, p. 1).

MOE further stated that, “Teachers and all MOE staff are benefiting from a responsive, sympathetic HIV/AIDS work place policy and should be proactive in combating HIV/AIDS as part of their normal functions. The output for learners at all levels is to: demonstrate a nationally defined set of age specific HIV/AIDS skills and competencies to deal with all aspects of the epidemic” (ibid.). The ministry called for a proactive approach by staff at all levels in fighting the epidemic, and also disseminating facts and preventive messages to both staff and learners within MOE. The approach also emphasized the need for resources and other inputs to be able to adequately deal with these challenges.

MOE highlighted its role and responsibility to work in close collaboration with relevant stakeholders fighting the disease, and commitment to the overall aim of creating “the future of a healthy, well-educated nation that is free of AIDS” (ibid, p.1). The first level objective according to the MOE was to improve management for HIV/AIDS by developing a support system to ensure that each school and college establish an HIV/AIDS committee to deal with every aspect of HIV/AIDS (MOE, 2001b). MOE also prioritized policy development to


allow schools to promote community-school initiatives for relevant local HIV/ AIDS activities.

Strategies This HIV/AIDS strategy replaced the circular submitted to all schools in 2000, where they were instructed to start each lesson with a 5-minutes sensitization on HIV/AIDS1. But the new framework did not specify the modes of implementation of HIV/AIDS prevention education, still a challenge for each district or school to develop.

In order to support the implementation of these policies MOE assigned one education officer at each administrative level, in addition the person heading any educational institution in 2002 was appointed as a Focal Point Person (FPP). The FPP should support and monitor the HIV/AIDS prevention education provided. Thereby every level and unit within the education sector, including MOE headquarter, had one FPP being responsible for the policy implementation.

There was one exception though. In spite of being the focal point for the decentralized BESSIP approach, according to MOE, there was no FPP within the district level. Instead, one senior Focal Point Teacher, having their regular teaching load at one of the schools in the district got an additional responsibility of being the district FPP. One of the consequences was that the multiple tasks expected from the appointed FPP, made it impossible to effectively facilitate the implementation and monitoring of the overall district level HIV/AIDS activities.

MOE followed up with new directives regards the management of the HIV/AIDS education in January 2004. Then each educational administrator, heading any office or institution was assigned to be responsible for the implementation of HIV/AID education within the sector. Those heading provincial and district offices were now directly responsible for ensuring HIV/AIDS education was being taught according to the national policies. In some cases, that change resulted in the continuation of existing practices, but in other cases, and as a part of the decentralization policy, it also allowed the leaders to find local solutions to managing the HIV/AIDS activities.

Over the next couple of years, there were ongoing changes and restructuring of roles and responsibilities related to HIV/AIDS education at all levels. In 2005, MOE reversed the 2004 directives, and made the guidance and counselling officer at central and province levels in charge for overseeing HIV/AIDS activities. However, at district level, they had to select a guidance and counselling teacher from one of their basic schools to take on the role of coordinating the HIV/AIDS activities at district level.

1 HQ info, 2002, sensitization was commonly used as a term referring to awareness-

raising


In January 2006, the coordinating role of the HIV/AIDS prevention education activities were handed over to the Human Resource Directorate which decentralized the responsibility to the Human Resource (HR) officer at province and district level, whereas the guidance and counseling teachers continued their responsibility at school level. The HR officers at district level main responsibility were employing teachers, examinations, and enrollment. Tthey did not maintain the same confidentiality towards staff, teachers and parents, which reduced their legitimacy to involve themselves in HIV/AIDS cases.

These ongoing managerial changes lead to high turnover and inconsistency of staff and responsibilities, which had a negative impact the overall quality of the HIV/AIDS prevention education delivery, from province to district and school level. Under these circumstances, it became difficult to coordinate and monitor the HIV/AIDS interventions comprehensively and systematically.

2.8 Syllabus, content and methodology

Basic education syllabi

Prior to the implementation of BESSIP and the development of new syllabi the MOE used circulars to inform, or rather give instructions to the school principals on how to address different tasks at the school level (MOE, 2003c). This was also the case with the introduction to HIV/AIDS education in 2000. MOE then sent out a circular to schools where the principles were told to assign the first five minutes of every lesson to address HIV/AIDS information or messages to the pupils1.

The new syllabi were produced as a result of the Basic School Curriculum reforms carried out by the Ministry of Education under BESSIP, from 1999-2002. The new school syllabi (MOE, 2003c) were more learner centered, included continuous student assessment and for Grades 1-7 HIV/AIDS education were explicitly mainstreamed and integrated across all subject areas emphasizing the important role life skills education.

In addition to the five core learning areas: 1) literacy and languages, 2) mathematics, 3) integrated science, 4) creative and technology studies and 5) social and development studies, a sixth learning area, community studies, was added to include relevant and localized content. Community studies should cover 10 percent of the timetable, about half a day of teaching within a given week (MOE, 2003c, p. vii), where HIV/AIDS were supposed to be integrated as a “cross cutting issue”2. 1 Information from MOE HQ, 2002, confirmed by PEO special needs advisor,

2003 (f.n.) 2 Cross-cutting issues included life skills, gender, human rights, reproductive health,

good governance, environmental education and water and sanitation.


Community studies acknowleded the communities’ way of life and imparted knowledge and skills to their children according to their own norms and values. The syllabi further explained that, “many of the local skills, particularly those that relate to behaviour and survival, are passed on from generation to generation as a part of the socialization process” (MOE, 2003c, p.124).

The community studies syllabus was designed to give the local community opportunities to participate in the planning, development and implementation of community studies learning areas, and thus recognized their ownership of the curriculum and their local school. It also was expected to improve the provision of education in rural areas, “…reducing rural-urban migration,” (ibid., p.124).

The approval of the localized curriculum was intended to be carried out at the school and community-level, and thereafter was sent to the central education system levels for comment and advice. The implementation of the curriculum would be carried out in conjunction with learners, teachers and members of the local community. Continuous assessment was recommended by MOE, as a part of a formative assessment procedure through regular feedbacks on progress, and record keeping, (MOE, 2003c).

HIV/AIDS was mentioned as a crosscutting topic only 32 times in the new basic education curriculum, grade 1-9. (MOE, 2003c). As an average, HIV/AIDS was specifically highlighted as a topic to integrating into regular subject areas approximately 4 times a year. However, in 20 out of these 32 instances, HIV/AIDS education was marked as an optional topic, and could therefore be dropped. The teachers were in other words free to prioritize other topics, to replace HIV/AIDS prevention. This could open up for selective teaching, in which teachers taught the topics they felt comfortable with, as revealed in the study of Action Aid (2003).

In the remaining 1/3 HIV/AIDS themes identified in the syllabi, e.g. an average of once a year, HIV/AIDS was specifically addressed as a compulsory topic. Three out of those twelve focused on transmission or prevention. For example, in grade four and grade five teachers were to discuss “ways in which HIV and sexually transmitted infections (STIs) are transmitted” (MOE, 2003c, p.36) and in grade two “how HIV/AIDS can be prevented” (ibid., p. 57). The content in the other ten incidents related to scientific knowledge and facts about HIV/AIDS, e.g nutrition, sanitation, blood transmission and infection, and what the acronym H-I-V-A-I-D-S stands for (grade two in, MOE, 2003c, p.30). It is important to note that there seemed to be little regard for cognitive and maturation levels of the learners when including a topic in the syllabus as evidenced by the grade two examples.

The methodologies recommended were consistent with the reorientation of pedagogy as stated in BESSIP, and were in line with the overall syllabus guidelines. According to the MOE, the teaching methodology for the new curriculum should be based on a communicative approach. The features included: using skills in real life situations, contextualizing the subjects, using authentic materials, linking the activities to real experiences for a real purpose,


ensuring the use of a variety learner-centred communicative, interactive and participatory techniques such as: role-play, drama, problem-solving, pair or group discussion, field trips or project work, case studies and debates (MOE, 2003c, p.3). In essence, the learner-centered and participatory approaches were the favored modes of teaching in this syllabus with a strong emphasis on making the teaching and learning relevant to the local context.

Interactive methodology A teacher’s guide titled the Interactive Methodologies Manual on HIV/AIDS Prevention in Zambian Schools (MOE, 2003a) was developed by MOE in 2003, to support the teachers. It was supposed to be distributed to the basic schools. Simultaneously MOE introduced a capacity building strategy to train the teachers, using a cascade training modality, e.g. training core trainers recruited basically from the teacher training colleges, in order for them to further teach and support grade one to grade twelve teachers to use the HIV/AIDS Manual. The main goals were to develop the HIV/AIDS education topics in the lesson plans the other was to apply and include new pedagogical approaches, participatory and learner centered methods. Interactive methods of teaching, according to the manual, would help avoid excessive use of lecturing focusing on giving information on HIV/AIDS, e.g. banking or teacher centered methodologies, to learner centered approach, helping learners to become partners in seeking information, analyzing and discussing the epidemic and ways to prevent infection (MOE, 2003a, p.ix).

The manual provides the teachers with a set of useful methodologies including modeling, role-play, problem-based learning, tableaux analysis, and the use of cultural tools such as proverbs, riddles, songs and dances. The manual also suggested the use of case studies of real life experiences, and participatory plays written or created with participation of the concerned community to generate interpretive discussions and problem solving (MOE, 2003a, p.116). It also recommended that teachers should conduct segregated gender group discussions with the aim of increasing female participation.

The manual also identified specific topics and activities by grade, and illustrated this by using colored codes. By doing so, the HIV/AIDS content was adjusted to fit to the specific needs and developmental levels of the students.

One important aspect here is tha the new approach to HIV/AIDS education contrasts the circular from MOE Head Quarter (HQ) in 2000, submitted to all schools, requiring that the teachers assigned five minutes of their lessons to HIV/AIDS sensitization. The guidelines also noted that the HIV/AIDS sessions should be 30-60 minutes long as HIV/AIDS were recognized as different from other topics due to its focus on attitudinal and behavioral change. But that recommendation actually goes against the main strategy (MOE, 2003a) for HIV/AIDS education prevention stating that HIV/AIDS should be a crosscutting issue, integrated in all subject areas.


The manual further guided teachers in group formation and management, interaction skills, planning, facilitating and evaluating discussions. It emphasized the a learner centered approach to principles of interaction, dialogue, sharing information and seeking new information in order to reflect upon previous perceptions. It emphasizing a problem-based approach, based upon personal responsibility to commit to their own intrinsic choices.

In taking this approach, the MOE also went against culturally accepted norms and traditions of reciprocity, obedience and collectivity. In seemingly recognizing this contradiction MOE made the following recommendation to teachers and other users: “Remember culturally children must not answer back to elders and adults, look in the face of elder adults when speaking, and show their feelings on their face but look down humbly” (MOE, 2003, p.8).

As can be seen from the previous quote, MOE acknowledged the subordinate and obedient role of the children in Zambia; that the children should not answer back to elders and adults, including parents and teachers, neither look in the face of elder adults. MOE go against these cultural practices, state that they should be discouraged in this era of HIV/AIDS so that learners can be more assertive and aware of their sexual rights and therefore eligible to say “no” to sexual advances of both their peers and elders (ibid).

The manual followed up with “hints” to support the teacher. For example, advising them to help students understand how communication involves listening, paying attention and showing respect for people’s feelings and views, and how body language plays an important role in communication. The ministry emphasized the need for collaboration and teamwork in fighting the epidemic, noting that, “The humans must work as a team to survive this challenge” (ibid, viii).

The guide also suggested ways of organizing some initial meetings locally, for instance with partners in school on AIDS education and how to map out strategies for working together. MOE (2003a) underscored that:

Team building is the foundation of networking and coalition building. In real life, the tensions and expectations created when a group of diverse individuals come together to work on a shared task exert a strong influence on how and when the group become a team (p. 109).

Culturally sensitive and other relevant topics were included in the manual, as issues of gender equality and empowerment of women as well as discussing and collecting local myths on HIV/AIDS, sexual abuse and stigmas. Factors and situations that might increase the risk of contracting HIV such as night clubs, bars and prisons and risky behaviors such as dry sex, casual sex, failure to use of condoms, multiple sex partners and early sexual activity were all included as topics for discussions.

The manual also promotes dialogues and group work related to how poverty, low social and economic status of women, settlement pattern and mobility may be related to the spread of HIV/AIDs. In contrast to the syllabi of


2003, the examples listed in the new Interactive Methodology for HIV/AIDS reflected and raised culturally and structurally factors, relevant and realistic factors related to the HIV/AIDS epidemic, its transmission modes and societal impacts in the Zambian context.

The manual takes as a point of departure, the context and the cultural realities pupils and families experience in Zambian society. This approach, in theory, allows for reflection and critical perspectives regarding traditions and practices among the students themselves and between the teachers and the pupils. The manual also highlights the use of local knowledge, local languages, and encourages teachers and students to be active in seeking local information and knowledge to understand and explain issues. MOE (2003a) also highlights the need for using the local language, which according to MOE is crucial in order for both teachers and learners to fully understand the relationship between scientific knowledge and the cultural impacts and conceptions related to the different HIV/AIDS discourses. Only by doing that, the content would be culturally and locally relevant.

2.9 Concluding remarks

In the southern African region, Zambia has been among the hardest hit by the HIV/AIDS epidemic. The epidemic has existed in Zambia since the early 1980s, with a peak in new incidences in the early 1990s. While the rate of incidence has become stable, a disproportionate number of young women have been effected.

A knowledge gap exists that needs to be addressed. As identified by NAC (2010), only 35 percent of Zambians could identify ways of preventing HIV/AIDS transmission and an alarmingly high number believed major misconceptions, illustrating that the majority of the population were lacking basic knowledge about HIV/AIDS. The fact that the largest proportion of the infected population is between 25 and 40 years, when young people are in their productive age, actively utilizing their education, skills and opportunities for individual and societal development, has had a devastating impact on the social wellbeing within families, and negative consequences for Zambia’s economic development

There has been a steady increase in the number of children having access to and completing school, as can be seen from the statistics from 2008 (MOE, 2008, p.30). The situation for secondary education, however, remains a story of limited access and completion with a 55 percent completion rate where more males than females gain access to tertiary education.

During the colonial and post-independence periods, the Zambian education system was heavily centralized but beginning with the policy framework, Educating Our Future, in the mid 1990’s the management of education became decentralized, the second steps were BESSIP (2001a) gradually leading to the National Implementation Framework (NIF) (2008). After several education


reforms after independence Zambia’s education system was aligned with the global education structure

Given the increase in access and completion at the basic education level, with close to 90 percent enrolment (ibid.) there are good reasons to argue, that outreach with relevant and quality HIV/AIDS education, could directly target the majority of the age group between 7 and 15 years old. Using the education structure to reach out to children and youth with HIV/AIDS preventive education, would be a means to bridge the information gap identified, as argued by MOE (2002).

The syllabus (MOE, 2002, 2003) and the HIV/AIDS education manuals (MOE, 2003) exposed the cultural barriers and hindrances one faced in bringing about HIV/AIDS education. Traditional practices such as sexual cleansing, initiation, and tattoos, as well as the taboos and stigmas related to even talking about HIV/AIDS and sex in the public are for the first time being addressed in the formal education system.

The HIV/AIDS curriculum is problematic in a number of ways, being linked to taboos, stigma and regarded as privazy. However, when HIV/AIDS were supposed to be taught as a crosscutting no single teacher got the overall responsible for teaching HIV/AIDS education prevention. In most instances, the topic was selective in nature, which according to Bohler (2003), in similar contexts results in selective teaching, where teachers tend to focus on scientific facts and information devoid of any cultural or traditional context. This further reduce the intended outcome of the interactive methodology on HIV/AIDS, that specifically emphasized HIV/AIDS education taught through a localized and contextualized approach applying learnercentered methods in close collaboration with the local community.

The following chapter is the theoretical perspectives and concepts used to analyse the data and try to understand how the HIV/AIDS education prevention strategies were developed, implemented and perceived among multiple stakeholders in Southern Province and provides the conceptual framework of the study.

Chapter 3

Conceptual Framework

The conceptual framework presented in this chapter, illustrates the relationship between macro– and micro level perspectives and strategies and how dualism may impact the implementation of any program intervention at various levels within the education sector. The framework further examplifies how Zambia adheres to and implement the global HIV/AIDS strategies (UNAIDS, 2001, 20002a), the so-called top down approach. The framework also includes the theoretical implications from a micro level perspective of development, a bottom up strategy, to help understand the processes and implications at play in decentralized HIV/AIDS educational prevention approach aligned with MOE’s national policies and strategies (2002, 2003) where the local actors have a key stake in the process.

In this study, the findings and discussions will focus on the ways in which HIV/AIDS education is being implemented within the Zambian education sector with an emphasis on the importance of adapting the strategies to the local contextual realities. In order to explore the complexities of change comprehensively and holistically, I have drawn upon different theoretical perspectives of development. In the following, I therefore lay out organizational and relational schema of the theoretical and analytical concepts that guide and explain the research process and the units of analyses.

3.1 The structural, cultural and constructivist rationale

The study draws upon three main theoretical perspectives of knowledge and learning as tools to analyze the integrated events, actors and perspectives of the global, national and local planning for and the resultant implementation of HIV/AIDS education within the context of one province in Zambia. The global ‘big plans’ for HIV/AIDS prevention education are analyzed through the lens of an educational rationale (Tjeldvold, 1999), a rational linear way of viewing educational development. A cultural rationale (Dobbin, 1994) is used to


understand localized decision making procedures, innovation and resistance from a situated and contextualized perspective during the development and implementation of HIV/AIDS education prevention. The constructivist rationale and Cultural Historical Activity Theory (CHAT) (Engeström, 1987, 2001) within this realm specifically is a key analytical tool to explore and try understand how the intersection and learning across these boundaries can take place at the individual, community, institutional and national level.

The linkages and relation between the cluster of the different concepts and theoretical perspectives applied are illustrated as in Figure 3.1. The educational rationale, comprises the Big Plans, reflects the top down, macro-level approach to development, based upon a technical and western rationale reflected in the UNAIDS global HIV/AIDS strategy. The cultural rationale takes the local context, relevance and needs as the point of departure. Whereas, what is termed the constructivist approach in Figure 3.1 emphasizes a cultural historical activity approach. The intervention at scrutiny aims at understand development strategies and how one can be build upon the merger of different perspectives or rationales, discourses and knowledge systems.

The core concepts and theoretical perspectives guiding the researc process builds upon. Dobbin (1994), distinguishes between the educational or structional rationale, characterized as linear and instrumental, reflecting what is being viewed as “universal” and global, bureaucratic laws as reflected in the global strategies, “the big plans” (e.g. Klees and Easterly, ch.1), also termed Global Architectures (Breidlid, 2015). This is supported by the world system theories, e.g. Meyer et al. (1997) showing how nation-states are directly or indirectly influenced by global culture and world models. This is in contradiction to the cultural rationale, which is dynamic and endogenous reflecting local sociocultural traditions and customs from as art and religion, oriented towards subjective, societal principles of human life (ibid.). The cultural rationale, taking Indigenous Knowledge System (IKS) as a point of departure, adheres to a more bottom up approach to solving problems.

A constructivist approach (Engeström, 1987), is reflecting a philosophical research methodology, Cultural Historical Activity Theory (CHAT) and expansive learning. CHAT gives insights into the important role of ideas, discourses and dialogues, by providing a dynamic approach to interventions and change represented by the interaction between the educationa/structional rationale and cultural rationale that under given circumstances may facilitate innovative steps leading towards new ways of perceiving the world, contributing to the development of new approaches and strategies.

In the following sections, I will explore theoretical concepts and their relevance for this research, providing background to the conceptual framework and by linking these concepts to explain the process of change and sustained cultural development.


The conceptual framework encompasses the intersection of the structural and cultural rational, the top down and the bottom up approach, and the arrow the intersection of these two approaches, by mediated action, e.g. through a constructivist approach, indicating multiple layers of interaction.

The vertical dimension, illustrates the micro versus macro-level actors and institutions, their HIV/AIDS prevention strategies, actions and plans. The horizontal dimension, then, illustrates the different epistemological positions, moving from the traditional societal and cultural practices and IKS, to be defined later in the chapter, towards the outer circle, representing western knowledge systems and secular values.

The arrow pointing to the center as well as to the outer circle, illustrates the interaction between the nested geographical units indicating the iterative process of a negotiated strategy between the macro and micro level perspectives influencing local and/or national transformation and development. In this model the perspectives of the structural, cultural and constructivist rationales can be located within the model of development which includes many actors, levels of engagement and events.

The following sections describe and define the various concepts and theories used in the study that further inform the findings of the study and their place within the overall conceptual framework.

3.3 Bio-ecological approach to development The point of departure is Bronfenbrenner’s (1979, 1999, 2004) theory of human development, also called a bio-ecological approach to development. The dialectic of the global and the local in the present study derives from the multiple layers and dimensions of interaction illustrating the contradictions that arise in international aid and development, at both national and individual level). The global context is represented through UNAIDS global strategies and framework for HIV/AIDS prevention. The different and distinct levels of geographic units are viewed not as disjointed or hermetically sealed spaces but rather as ecological environments, conceived as a set of nested structures, social, cultural and economic, each inside the next where the various levels mutually influence and shape each other. According to Manzon (2007, p.129) “the recognition and understanding of the mutual relationship subsisting across each of the spatial levels is indispensable for a holistic comprehension of the essence of educational phenomena”, here reflected through the Zambian HIV/AIDS education strategies (MOE, 2001b, 2003).

Bronfenbrenner recognizes development as a dialectical process, where there exists an interrelationship between the various levels. From the inner circle representing the setting within which the individual is behaving at a given moment in his or her life, his/her family and closer environment, called the micro level, expanding outwards like an onion to the context of the global level; the

Conceptual Framework 57

macro layer. The set of microsystems also constitutes the individual’s developmental niche within a given period of development. This may also include the mesosystem, which, according to Bronfenbrenner, is the interrelations among major settings containing the developing person such as the community, school, church, family, peers and local environment, all of which forms the contextual realities of the individual. This is indicated by the yellow layer in Figure 3.2, between the micro and exo layer in the quadrant.

The exosystem is composed of contexts that have an influence on the person’s behavior and development without directly involving the developing person, but affecting the person indirectly. In the context of the study, this relates to various discourses on HIV/AIDS, conflicting messages, expectations and norms as a result of the multiple actors and variety of ongoing interventions. It also contains specific social structures, formal e.g., schools and education as well as informal. The knowledge systems and structures that do not themselves contain the developing person but impinge upon or encompass the immediate settings in which the person is found, and thereby delimit, influence, or even determine and control what goes on there are considered to be an informal social structure (Lerner, 2005).

The macrosystem is the superordinate level of the ecology of human development, expanding outwards towards the global level. It is the level involving macro-institutions and public policy and will therefore include the global influences, which in many domains are over-ruling the national, regional and local priorities and needs. The UNAIDS global strategies, including the educational response to HIV/AIDS constitutes one of these super ordinate forces, the “big plans” or world models that may contrast, compliment or be a part of the ongoing global as well as local discourses on the subject.

The ecological model in Bronfenbrenner’s later writings expanded into what was termed the bio-ecological model (Bronfenbrenner, 2004), where the individual is included in it as a function of biology, psychology and behavior, and thereby fused dynamically within the ecological system. The dimension of time was included and conceptualized as involving the multiple dimensions of temporality, constituting the system that moderates change across the life course (Lerner, 2005, p-xv). Within bio-ecological theory, relations between the active individual and the changing environment, in this case the impacts of HIV/AIDS, constitute the basic process of human development.

As a consequence of the holistic concept of a bio-ecological model, Bronfenbrenner (1999, 2004) expanded the definition of the microsystem to also include activities, social roles and interpersonal relations experienced by the developing person in a given face-to-face setting with particular physical, social and symbolic features. These invite, permit or inhibit engagement in sustained and progressively more complex interactions and activities in the immediate environment (Lerner, 2005, p.xvii). This is consistent with Lave and Wenger’s (1991, in Contu and Willmot, 2003, p.6) views on how shared cultural systems of meaning and political- social- and economic structures are interrelated, in this


case HIV/AIDS and national and individual impacts, and how they help to co-constitute change through participation in social practices and activities as a socio-cultural phenomenon.

Individual’s contribution to development is made possible by a synthesis and integration, between the active person and his or her active context. The individual development, as described by Vygotsky stems from the micro-level context of the zone of proximal development (ZPD), defined as “the distance between the actual developmental level as determined by independent problem solving and the level of potential development as determined though problem solving under adult guidance or in collaboration with more capable peers” (Vygotsky, 1978, p.86).

In other words, development from a bio-ecological perspective takes into consideration the importance of power as a determining factor for the proximal developmental processes (Lerner, 2005). This attention to power, culture and language is reflected in the importance placed on defining the dominant discursive voices in a given time. By including time and development over the life course of an individual, Bronfenbrenner’s bio-ecological model also recognizes the importance of historicity and context as elements in human development (ibid). Human actions are context specific, reflected by and mediated consciously or unconsciously in any culture throughout history.

3.4 Culture, world-views, and world values “Culture” has many different definitions. Tylor’s wide definition of culture is defined as the “complex whole which includes knowledge, belief, art, morals, law, custom, and any other capabilities and habits acquired by man as a member of society” (Tylor, 1871, p.1 in Gausset, 2001, p.150). Berger and Luckmann (1967, p. 67) view culture as a “body of knowledge”, e.g. the reality about our every-day-life, a common sense taken for granted. Whereas Hofstede (1989) defines it as “the software of our minds”, guiding and determining our views and actions.

In this study, culture is viewd as Hoftede defines it, the software of our minds. It comproses whatever norms and values transmitted to the next generation learned as a subjective truth in the course of socialization and internalized as our subjective reality. It includes “the whole complex of distinctive spiritual, material, intellectual and emotional features that characterize a social group...modes of life, fundamental rights of the human being, value systems, traditions and beliefs…” (Findings, 2005, p.3). Culture in the specific sense is “the patterned way of life shared by a group of people” (Nanda, 1987, p. 68, quoted in Gausset, 2001). Practices reflecting culture, traditional and spiritual beliefs and practices, are undoubtedly enhancing the spread of HIV/AIDS in Zambia. The challenge is trying to understand how to avoid behavior putting the population at risk of contracting HIV/AIDS.


Gyekye (1997) distinguishes between culture and tradition. He argues that cultures and traditions quite often are being used synonymously, as they both are socially inherited beliefs and practices identified as authoritative traditions that affect the texture of our lives (ibid.). He claims that a cultural practice evolves into a tradition if it passes through several generations. A tradition then is being defined as any cultural product created or pursued by past generations and that, having been accepted and preserved, in whole or in part, by successive generations, has been maintained to the present. From this definition, it follows that culture includes beliefs and practices that are placed at the disposal of the new generation in the anticipation that that the next generation will preserve them. Some values and practices may therefore for one reason or the other not be accepted, and therefore not maintained (ibid.) as some of the drivers of the HIV/AIDS epidemic are directly related to cultural practices and rites that ultimately put people in situations where their lives and communities are at risk. According to Gyekye’s (1997) theory, traditions may die out if they are deemed harmful to future developments.

World views

World-views are shaped and constructed by cultures (Barth, 2002). They also reflect how cultures and typology of actions affect and shape our institutions and organizations by constructing our reciprocal actions that constitutes the institution, our “taken for granted” procedures e.g. ways of working and how people relate to each other and the society as a whole. Focault (in Ransom 1997) argues that dominant discursive regimes work through these typifications, the concepts, conventions, classifications and categories that we use to analyze, construct and describe reality; through them we acknowledge what is seen as true or false, normal or abnormal, right or wrong. The legitimacy assigned to these dominant regimes stems from the contextual foundation or rationale, e.g. the processes guiding the construction of these typifications. Development aid, rooted in a western, global discourse also represented by the “world models” may in a given development contexts overrule a national and/or locally developed regimes of action, or typifications illustrated by the impacts of the global HIV/AIDS strategy in the introduction.

The cultural and traditional perspectives and practices reflecting the contextual realities in the Zambian society, specifically emphasizing issues impacting the HIV/AIDS epidemic have been described in Chapter 4. The cultural specific actions or habitualized actions (Berger and Luckmann, 1966, p.3) occur whenever there is a reciprocal and shared typification of actions by a type of actors (ibid., p. 54). These cannot be viewed as purely individual, but have to be viewed within the context of the activity and its subjects. Local typifications of actions are therefore critical when analyzing local developmental processes, as well as the role and impacts of the various actors or stakeholders influencing and


determining the development and implementation of preventive HIV/AIDS strategies and actions.

Studies have shown that despite wide differences between countries and local communities, African indigenous philosophies and belief systems in general situate the individual socially (Gyekye, 1997; Huntington, 2000). The social interconnectedness therefore recognizes a typology or typification of the African culture captured in the word Ubuntu. According to Mbigi (1996, in Van der Colff, 2003) “the main stem that underpins most values of African history can be traced through Ubuntu. Ubuntu can be seen as the key to all African values. It involves collective personhood and collective morality” (ibid. p.257). Brodryk (2006) further elaborates on the African way of life by translating ubuntu as “brotherhood” or “togetherness”, with reference to the collectivity, e.g. “a person is a person through other persons”, and social and physical inter-dependence of people (ibid).

The morals and customs are learned in the atmosphere of the family and extended family. This family atmosphere of ubuntu is regarded as the basis of African law, where one recognizes the rights of groups, which always precedes and supersedes individual rights. A person should therefore involve others as brothers, sisters or team members for general life support. As teams, the problems of life seem to be lighter since there are a variety of inputs and advice derived from relevant experiences “As individuals people are weak: if they stand together and rejoice collective co-existence, they are strong” (ibid. p.6). Considering the importance of involvement and collectiveness reflected in ubuntu, reflecting an African societal way of living, indicates the importance of collaborative action and decision-making procedures, if building upon local traditions and practices.

World values

The links between culture, values and world-views across countries, have been studied by Hofstede (1991) and Inglehart (2005). Through cross-national comparisons they identify correlations between typifications of culture, world views and attitudes, “features that characterize a social group” (Findings, 2005, p.3), impacting how a given population will perceive and act in a given context.

Inglehart (2005) uses world values survey research to map a country’s basic values, and his findings reveal that a large number of common basic values in any given country can be identified. He further argues that the values comprise all major areas of human concern, from religion to politics, and from economic to social life. According to Inglehart (2005). The overall result from his studies can be depicted in two major dimensions of cross-cultural variation, namely the Traditional/Secular-Rational values dimension and the Survival and Self-expression values.


In his World Value Model, Inglehart (2005) positions all the African countries assessed to have a strong affiliation to traditional as well as survival values whereas most of the Western countries by contrast are found clustered around self-expression with a secular domain. Although the countries do vary, as underscored by Inglehart (2005), the most outstanding contradiction between the Western typification and the African (including Zambia1), is between Self-expression and Survival values and between Secular-Rational and Traditional values. Traditional societies, including most African and also South Asian countries hold religion as very important for emphasizing strong parent-child ties and deference to authority, along with absolute standards and traditional family values. Societies with Secular-Rational values, mainly consisting of the European and English-speaking countries have the opposite preferences.

When working in a multicultural environment, the different world-views as reflected above, may influence how the different actors involved in aid and developmental work will guide and assess possible optional strategies, viewing authorities and considering e.g. the role of different actors. This is equally important when looking into the other dimension of cross-cultural variation, which focuses on Traditional-Survival values where the emphasis is on economic and physical security, reflected in mass polarization over tolerance of out-groups (e.g. foreigners, gays and lesbians) and gender inequality. The countries clustered within the Secular-Rational/Self-expression domain, mostly countries from the global North emphasize imagination and tolerance as important values going with a rising sense of subjective well-being conducive to an atmosphere of interpersonal trust and political moderation. Tolerance as opposed to stigmatization of out-groups, e.g. marginalized or minorities, certainly impacts the situation of PLWH, their family members and the general “culture of silence” that characterize the HIV/AIDS discourse in Zambia, issues that may add to an understanding of the contextual realities surrounding the epidemic.

Inglehardt’s typification of values and country clusters correspond with the findings from Hofstede’s (1991) longitudinal research where collectivism, as opposed to western individualism were the cultural dimension commonly shared by countries in the Sub-Sahara region. As echoed in findings (2005, p.4) “Africans therefore provide a consistent counterpoint to the individualism dominating Western philosophy, both from an individual as well as societal perspective”. The practices and assumptions of international, Western development institutions and practitioners are therefore at odds with the dominant African indigenous practices (ibid.). The African ubuntu, or “togetherness” previously discussed, clearly illustrates this dichotomy. These cultural typifications illustrate the multiple perspectives and multiplicity of voices characterizing joint development activities in a global context. 1 East African countries, include Zimbabwe and Tanzania. Zambia had not yet been

included in the world values survey but for the purposes of this analyses, it is assumed the typifications will be in proximity of these two neighbors.


Sydhagen and Cunningham (2007, p.127) have compared these cultural characteristics between Western and African worldviews and argue that the main differences are linked to their historical development of being colonized, oppressed and subordinate, versus the Western colonizers’ sense of superiority. The Westerners are individualistic versus collectivistic, have a direct and clear communication versus Africans’ communication style characterized as indirect and ambiguous. Western oriented countries tend to have a low power distance (individuals viewed as equals and superiors and subordinates are interdependent) versus Africans having a hierarchical working climate, reflected in the contrast between a Western delegation of authority versus an African propensity for pushing decisions upwards in the organizational hierarchy. This encourages dependent behavior, and reduces opportunities for sub-ordinates to engage in more interesting work. What is termed ‘technical intelligence’ e.g. scientific and rational competences are prioritized in a Western perspective, as opposed to ‘social intelligence’, highly valued in the African context, (Ferrarro (2001), Hofstede (1991), Jackson (2004) and Thiemann (2005) in Sydhagen & Cunningham, 2007 p. 127). In a decentralized context, dependent behavior and a tendency of pushing decisions upwards might be a challenge for local decision-making and innovation also in HIV/AIDS prevention activities, as might be the case where scientific and so called rational behavior contradict social and spiritual knowledge.

Their overview of the core features characterizing the Western and African world-views is merged with Inglehardt’s (2005) findings on world values. Table 3.1 provides a summary of some of the potential contradictions that might appear in a multi-cultural and multi-voiced planning context affecting the processes involved in any developmental agenda.

Table 3.1 Typology of Western and African planning processes

Western African

Democratic participation Deference to authority Secular orientation Spiritual and religious orientation Tolerance of diversity and out-groups

Intolerance of out groups and marginalized

Focus on gender equality Subordination of women Child-rearing values emphasize imagination and tolerance

Strong parent-child ties and absolute standards based upon traditional family values

High interpersonal trust Low interpersonal trust outside their own kinship, specifically towards foreigners.

Key issues that are relevant in this study are deference to authority, intolerance of out groups, low interpersonal trust, child-rearing standards and attitudes


toward gender issues. The west is characterized as having high interpersonal trust, combined with tolerance and a focus on gender equality, as revealed in the study of Hofstede (1991) whereas African values traditionally reflect the opposite. The spirituality, reflected in African worldview, which is of relevance in this context, is also at odds with the traditional secular orientation in the western world’s (Inglehardt, 2005). These differences illustrate potential clashes and challenges; a strategy mainly built upon western scientific rational values might face opposition when confronting spiritual reasoning and world views.

A caveat should be mentioned regarding cultural typification. As the concepts above all are constructed, the classifications are also expressions of the power exercised by discursive regimes, and thereby also become means of exercising power, as we use them to shape policies, practices and relationships (Ransom, 1997, p.129). Sen (2006) also critiques the use of cultural classifications as they may serve as the intellectual background legitimating typifications of cultures. Conceptually, Sen further argues (ibid., p. 10) these categorizations correspond with civilizational lines that closely follow religious attention and therefore “The alleged confrontations of religious differences are incorporated into a sharply carpentered vision of one dominant and hardened divisiveness” (ibid.).

The same argument is being raised by Said (1993) proposing that when using such dichotomies, it usually ends up in polarizing values, that limits an open multicultural approach or meeting between cultures, traditions and societies (ibid., p.120). Instead, one should explore how one constructively can build upon culture for development and multicultural understanding, being critical and aware of our own biases, and at the same time acknowledge and recognize the world-views from a multicultural point of view, he argues.

This coincides with Hofstede’s (1991) advice, urging that one can and should not apply these values to groups or individuals within any society but rather view them as guiding and enabling tools and means when working in a multicultural environment. But some of the typologies identified may help to understand the processes, procedures and activities addressed in the study, as an ‘enabling tool´, to quote Hofstede (1991), to initiate actions that mediate learning aimed at local transformation and development.

3.5 Epistemology of learning Learning processes have, according to Engeström (2008a) traditionally been characterized as a vertical or linear input oriented model of learning, e.g. processes where a subject, acquires some identifiable knowledge or skills in such a way that a corresponding change in the behavior of the subject may be observed. This linear understanding, also referred to by Contu and Willmot (2003, p.34) as established, transmitted by the “one who knows”, tends to be theoretical and what might be characterized as a form of universal truth.


According to Lave and Wenger (1991, in ibid.) learning is viewed as something located or ‘situated’ within everyday practices and conceive it as an integral part of generative social practice in the lived-in world. An adequate understanding of learning, they argue, must then acknowledge its embodied (‘lived-in’) as well as its historically and culturally embedded (‘generative’ qualities). Their situated learning theory views learning as a pervasive embodied activity involving the acquisition, maintenance and transformation of knowledge through processes of social interaction. The central issue is a demonstrated ability to understand the local context and act in ways that are recognized and valued by other members of the immediate community of practice. “In this respect, learning is not adequately understood as the transmission/acquisition of information or skill but inter alia ‘involves the construction of identities’” (ibid. p.6). Knowing is then socially recognizable in action as a part of a social practice (Mäkitalo, 2012, p.61), whereas learning emerges in situations where gap-bridging, meaning-making and coordination of actions and perspectives are necessary to carry on either with on-going activities or transformed practices.

Engeström (1987, 2001a) argues in a similar vein that, transformations even from our personal lives as well as organizational practices originate from new forms of activity/ies which are not identified a priori. Learning is generic and contextual where raising discourses about existing practices, giving reasons for the standpoints, arguing, negotiating and dialoguing we actually learn while the activities are created (Engeström, 2001a, p. 138).

A situated or contextualized perspective on knowledge, regards knowledge as constructed through interaction with the environment (Bronfenbrenner, 2005) in a dialogue with others (Vygotsky, 1999), mediated through interaction and reflection. A constructivist perspective of knowledge includes the premise that knowledge is contextualized within a given culture and language, and that knowledge is created through a process where new perceptions and under-standings are interacting with prior knowledge and experiences of the learner.

Situated or contextual knowledge is embedded in community and identity formation, and also termed indigenous knowledge. A summary of the two perspectives on learning can be found in Table 3.2 below. The dichotomies illustrate some key differences in how different knowledges are recognized and valued by others.

Knowledge for local transformation and development is situated and context sensitive. According to Contu and Willmot (2003), an approach where the learning process is embedded in the community requires the inclusion of IKS and can be developed through horizontal collaboration. This also coincides with Engeström’s (1987, 2001) third generation of Cultural Historical Theory (CHAT) as will be further elaborated on later in this chapter. In the following horizontal and situated learning will be explored by looking into how Vygotsky and colleagues were engaged in studying transformation through the social formation of the human mind already in the early 1900s.


Table 3.2 Established and situated conceptualizations of learning

Conceptualization Established/ Linear Situated/Contextual

Learning Cognitive – passive – selective

Embedded in community and identity

Forms of knowledge Canonical, theoretical, codified, distilled in text and manuals

Indigenous, embodied, context-sensitive

Understanding developed Abstract, Universal Transformation

of identity

Transmission Vertical instruction by authorities

Horizontal, collaboration with peers

Source: Contu and Willmot (2003, p.34)

Western and indigenous knowledges

The construction of the Western notions of knowledge is based on the Greek model as a relatively recent construction beginning with the European Renaissance according to Asante (2003). He proposed that only the Europeans were entitled to and had the ability to construct rational thought (ibid). A commitment to a particular knowledge system though not only predetermines the kinds of generalizations made about the subject under investigation but also provides the means for changing the world (Guha 1997, in Bankoff, 2001, p.17).

In any society, certain “cultural forms” and “ideas” dominate over others: the “form of this cultural leadership is what Gramsci has identified as hegemony” (Williams et al, 1993, p.1 in Clarke, 2008). The discursive construction of Western Eurocentric knowledge as hegemonic has been possible because of an asymmetrical relationship of power of domination, of varying degrees of a complex hegemony in the encounter of Western and African knowledge. This has been developed over the past five hundred years, as African cultural-, economic-, religious-, political-, and social terms have existed primarily on the periphery of Europe (Asante, 2003).

Historically, the colonial education provided a key mechanism for the spread of contemporary forms of education. The colonial education systems in sub-Saharan Africa reflected the structure adopted during the colonial aera (Altbach & Kelly, 1978 in Tikly, 2001). The nature of the educational program of the colonizing power although differing in some respects, spread a common structure of schooling throughout the region. “It also spread a form of curriculum based on an episteme (ground base of knowledge) with its roots in the Greco-Roman”, being scientific and rational building upon Western traditions (Tikly, 2001, p.7). Colonial education in the African continent was almost exclusively built on a Western epistemology, as opposed to the traditional African knowledge system, situated and context sensitive, building upon communal values in close horizontal and collective interaction (Contu and Willmont, 2003).


African knowledge systems can be clustered under the umbrella termed Indigenous Knowledge System (IKS), recognized as the knowledge people in a given community have developed over time, and continues to expand. It is contextual, based on experience, embedded in culture and identities, often tested over centuries of use, adapted to local culture and environment, and is dynamic and changing (IIRR, 1996).

IKS are by definition interdisciplinary as local people think of and manage their natural environment as a whole system. IKS bridges the spiritual with the physical world. Therefore, there is strong relationship between cultural embeddedness of knowledge and how that creates meaning.

Indigenous knowledge is situated and context specific but has the potential to be applied to other regions, being transferable and having time-tested reliability (Sillitoe, 1998). Participation in social practices is accordingly, a socio-cultural phenomenon, to be understood as a complex participation in wider social relations, e.g. ‘ubuntu’ in the context of Sub-Sahara Africa. The shared cultural systems of meaning and the socio-economic and political structure co-constitute the situated learning in communities of practice (Lave and Wenger, 1991, p.54, in Contu and Willmot, 2003, p.6).

The notion of situated learning and learning in action is consistent with many traditions in the social sciences that have been influenced by Vygotsky and other Soviet constructivists, conceptualizing the notion of language as action and embedded in practice (ibid.). In the following section learning mediated through, communication and dialogue as a tool or artifact, creating multiple potentials for change and transformation will be explored.

3.6 Communication in human activity and learning The Soviet school of thought argued that humans transform the environment in which they live through tool-meditated activities (Vygotsky, 1978, 1999) Vygotsky’s studies revealed that participation in such activities also had the potential of re-organizing the human mind, and stated that the human mind is transformed through tool-mediated activity. In this communicative process “the language is the tool of tools” (ibid). His work paved the way for a view of learning as an emergent property of social activity, and as such, the most prominent driving force for cultural development (Mäkitalo, 2012, p.62). Understanding the notion of mediation, how macro- and exo- realities are mediated to the lower levels and visa versa may then help understand human and environmental transformation.

Vygotsky addressed mediation in terms of meaning, sense-making and other constructs in his discussion of human communication and how speech mediates human consciousness. As such, the communicative signs involved are part of an ongoing stream of communicative action also brought into contact with other forms of goal-directed behavior (Wertsch, 2007). Learning happens


as ‘sign meaning develops’ and transforms our communicative action (ibid., 2007, p. 186).

An important part of Vygotsky’s notion of mediation is that learning first appears on the social plane. The central role of tools, or artefacts in social practices serve to remind us of how dialogue, reasoning, social action and material tools are intertwined. As Mäkitalo (2012, p. 63) explains, “the first stages of acquaintance typically involve social interaction and negotiation between experts and novices or among novices in social activity”. Language, both physical tools and signs, are dead entities by themselves and do not become instruments of action without the semiotic interaction of a social group. The meaning of a word is determined entirely by its context. In other words, the meaning of a word is inseparable from the concrete situation (ibid., p. 79).

In such a perspective on language, the categories on which people rely when coordinating their social actions have meaning potentials, and they are made sense of both in the contexts of in situ interaction and within the sociocultural practices established over long traditions of indulging in such interactions (Linell 1998, p.54, in ibid.). Historicity and sociocultural practices thereby regulate the meaning-making potential in a given context, guided and controlled by the dominant discourses. Sense- and meaning-making aligned to the local culture and context in a HIV/AIDS context, or any other local development initiative, requires in depth knowledge. Being an outsider, e.g. an international expert, without in depth knowledge of the concrete situation, requires in depth explorations and the identification of innovative strategies to limit that knowledge gap.

Multicultural guided interventions are never free from one’s own cultural history (Cole, 1996, Omemoto, 2001). When mediating cross-cultural work, the Soviet cultural, historical psychological tradition, according to Cole (1996) offers a way of building up a theory of culture in mind1, beginning from the organization of mediated action in everyday practice (Cole 1996, p.116). Culture, this thesis will argue, being the software unconsciously guiding our actions (Hofstede, 1991), can be viewed as a tool or an artifact mediating individual or organizational activities whereby professionals, experts and novices create innovative action stemming from their everyday life and world views. These activities constitute a way of making sense of the traditional and cultural ways of knowing on the basis of new knowledge and perspectives when shared by members of a given group or society where “such (new) knowledge is frequently employed conjointly by people” (Watson, 2009, in Mäkitalo 2012, p.64). Cultural sense-making as an individual process in such activities is therefore a social matter since socially shared meaning-making are part of the situated practice. Understanding culture, then, both as an explicit and implicit mediating tool, organizing perceptions and actions in a situated context and guiding the course of action, illustrates a culturally mediated action or activity. 1 Author’s italics


Explicit and implicit mediation

Mediation is associated with the use of tools, especially “psychological tools” or signs and artifacts. It builds a link between social and historical processes on the one hand, and individuals’ mental processes on the other where the basic mediational triangle is being used as the foundation of analyzing and understanding individual behavior by examining the ways in which a person’s actions performed on objects are culturally mediated according to Vygotsky (in Wertsch, 2007, p.178). From a Vygotskyian perspective, our mental processes are internalized as they are mediated by our socio-cultural and historical institutional forces. Wertsch (2007, p. 180) expands Vygotsky’s concept of mediation by defining explicit mediation to involve the intentional introduction of the signs, tools or artifacts into the ongoing flow of activity.

Implicit mediation, in contrast, tends to be less obvious and therefore more difficult to discover. It does not need to be “artificially and intentionally introduced into ongoing action. Instead, it is part of an already ongoing communicative stream that is brought into contact with other forms of action” (ibid., p.180). Implicit mediation is characterized by its involvement of signs, especially language, whose primary function is communication and social interaction. In contrast to the case for explicit mediation, these signs are not purposefully introduced into human action, and they do not initially emerge for the purpose of organizing that action. Instead, they are part of a pre-existing, independent stream of communicative action that becomes integrated with other forms of goal-directed behavior (ibid.). The lack of transparency of the signs and artifacts in implicit mediation is exacerbated by the fact that they preexist in communication and are often not consciously introduced into a problem solving or memory task setting as mediational means (Wertsch, 2007). This can be illustrated by informal communication in relation to the ongoing HIV/AIDS discourses, conducted by individuals with family members in their respective households, within the community or among peers in informal settings, situated and contextual, independent of time and or space.

Explicit mediation is intentionally introduced e.g. through formal education or problem solving activity, often mediated by an outside party or any other assigned person. Any goal driven development project involving tools or artifacts to mediate action would also be characterized within the context of explicit mediation, which also reflect the activities and actions conducted in relation to the research under scrutiny.

To further analyze the process of collective mediated action, and to understand culture both as an explicit and implicit mediating tool, a deconstruct-tion of the concepts, the signs and tools, e.g. artifacts, will give a deeper understanding of the cultural impacts on change and transformation. Wartofsky (in Cole, 1996) offers a broader understanding of the importance these cultural artifacts in his three-levelled hierarchical framework.


Artifacts as hierarchical mediating tools

Wartofsky (1973, in Cole, 1996, p.120) described artifacts as “objectifications of human needs and intentions already invested with cognitive and affective content”. He proposes a framework consisting of a three-level hierarchy of primary, secondary and tertiary artifacts. The primary artifacts are the tools directly used in production, e.g. axes, clubs, needles, bowls (ibid.), as well as language, as manifested through words, writing instruments, and media. In addition, he introduces what he terms mythical cultural personages and includes these within the category of primary artifacts. The “mythical cultural personages” has a mythical and spiritual function in a given society, e.g. the role and position inherited by the chiefs in Zambia. The primary artifacts are all considered to correspond to the concept of artifacts as matters, transformed by prior human activity with the purpose of transforming practice.

Secondary artifacts consist of representations of primary artifacts and are playing a central role in preserving and transmitting modes of actions and beliefs, he further argues. They include e.g. recipes, traditional beliefs, norms, constitutions and the like (ibid.). Traditional beliefs, norms and practices are an integral part of the Indigenous Knowledge Systems (IKS). The behavioral representations of these primary artifacts, relate to cultural and traditional practices including sexuality and gender specific attitudes and norms in the Zambian society, illustrating clearly how the secondary artifacts directly impacts the typification of action in a HIV/AIDS context.

The third level of artifacts “can come to constitute a relatively autonomous world in which the rules, conventions and outcomes no longer appear directly practical or which seem to constitute an arena of non-practical, or free’ play or game activity” (Wartofsky, 1973 in Cole, 1996, p. 120). These imaginative artifacts can come to color the way we see the ‘actual’ world, providing a tool for changing current praxis (ibid). For example, the modes of behavior acquired when interacting with tertiary artifacts can transfer beyond the immediate contexts of their use, e.g. perceptions, works of art and processes. According to Cole these conceptions can be generalized by linking “the notion of artifacts, on the one hand, to notions of schemas and scripts on the other hand” (ibid., p.121). Schemas and scripts may include authoritarian schemas and scripts, which mediate and control peoples’ actions in a given context. They may as well be contested through contemporary sciences, Western knowledge or even legislative laws, as is the case of several customary laws in Zambia. The contestation of existing contradicting artifacts is consistent with Gyekye’s perceptions of what might impinge cultural transformation and change. Cultural practices and traditions being passed from one generation to the next are not necessarily sustainable unless they are received and appreciated by the next generation (Gyekye, 1997).

Based upon this characterization of artifacts as the core of cultural mediation as suggested by Wartofsky, the next step according to Cole is to look


into ways in which these hierarchies of artifacts are woven together in the process of joint human activity. Geertz (1973, in Cole 1996, p. 122) suggests that culture is those webs that can be identified by “an animal suspended in the webs of significance he himself has spun”, or like an analogy with a “recipe or a computer program” (ibid.) referred to as a control mechanism. His conception of culture as inside-the-head-knowledge (or internalized knowledge) is consistent with the notion of artifact mediation. Viewing culture as a “control mechanism” assumes that human thought is basically social and public. The web-metaphor or recipe metaphor suggests that the patterning of culture is local and specific to particular ingredients or contexts and circumstances.

As human activity involves elaborate and shifting divisions of labor and experience within cultures, “no two members of a cultural group can be expected to have internalized the same parts of whatever whole’ might be said to exist” (ibid.). The locally diverse causes and practices for contracting HIV/AIDS as described in Chapter 5 clearly reflect this cultural diversity, within an umbrella capturing a more stereotyped picture of common typifications. This use of artifacts, their hierarchical structure and how they impact people actions has been instrumental in this study’s analysis.

3.7 Explicit mediation and significance of schooling The agendas of schooling are an explicit mediation of knowledge as a key for social action, individual and national development (Serpell, 1993). According to Serpell, these agendas can be divided into three core areas, reflecting an economic, a pedagogical and a cultural dimension of development that all are supposed to be harmonized at the individual school level. Darnell and Hoem’s (1996) views coincide with these perspectives. They argue that the school always has to be seen as a part of a larger societal system. At the macro level the school can be understood as a social system constituting a subsystem of the total society, adhering to a national agenda. But at the same time, the single school can also be seen as the educational system for a given community, municipality or town. At the micro level, learning through schooling have a clear mandate, it is explicitly mediated by teachers through the tools and artefacts in a given formal school context.

Serpell (1993) elaborates on the pedagogical agenda of schooling, related to cultivating intellectual and moral development. This presupposes a degree of social consensus on what constitutes appropriate ways of preparing children for their later life, he further argues, as socialization and identity construction starts during the early years of childhood. His research in rural Zambia reveals that the lack of content relevance creates a gap between the values reflected in the school curriculum, and their home environment. In most cases, the school may operate, either on its own, emphasizing Western knowledge and achievement levels with or without integration into the larger community, and unaffected by the


indigenous society without community involvement. The relative power of the various parts in such a disintegrated learning environment needs to be identified in order to analyze the function of a transformed system.

In a study on the relationship between schooling and community values by Darnell and Hoem (1996) among the Greenland population, they found that where the school built upon values and interests shared among the broader community, it strengthens the socialization and learning processes, but on the other hand, where these values and interests contradicted each other, de- or re-socialization occurred. Said with the words of Serpell (1993) the rural schools were rather alienating children from the overall community, its traditions, values and interests. One main challenge in fighting HIV/AIDS through educational preventive interventions therefore is to bridge the knowledge gap between the school and the community, e.g. the families and the broader households, to create an environment for HIV/AIDS preventive actions.

HIV/AIDS education, as reflected in the HIV/AIDS guidelines (MOE, 2003a) analyzed in chapter (2) was mandatory. At the same time the syllabus clearly addresses the importance of relevance and cultural alignment, in order to facilitate a conducive learning environment for HIV/AIDS prevention. This should happen through implicit as well as explicit mediation within the context of education, as well as through collaboration with the broader community level.

This gap can also be viewed from an epistomological perspective, where the educational and structural rationale, reflecting Western scientific knowledge intersect with the cultural rationale, built upon situated and indigenous knowledge. This tension is also illustrated by the arrow between micro- and macro-level interactions in the conceptual framework Figure 3.1. When exploring transformative action in a context where everybody was impacted by the HIV/AIDS epidemic; where scientific knowledge through HIV/AIDS prevention education was introduced in the school curriculum; where illiteracy and lack of information reflected the everydaylife of most of the community members; the intersection of these two knowledge systems emerged as core challenges when trying to understand the processes at play during the intervention period.

Based upon the concepts and categories that emerged when applying a constructivist grounded theoretical methodology, built upon the patterns and relationships among them when using NVIVO. The study adapted a version of the third generation of Cultural and Historical Activity theory (CHAT) as developed by Engeström (1987, 2001, 2008) as a tool to analyse the findings. This is further explored in Chapter 4, the methodological chapter. Activity theory (CHAT) as developed by Engeström (1987, 2001, 2008) as a tool to analyse the findings. In the following section, a brief introduction of that theory, its concepts and utilization as an analytical tool in this study will be explained.


3.8 Cultural and Historical Activity Theory Vygotsky (1999) argues that learning is fundamentally a socially mediated and constructed activity, mediated through language in a context of interpersonal interactions where the Zone of Proximal Development (ZPD) is the difference between what the learner knows and what the learner is capable of knowing or doing with mediated assistance. Leontiev (1981 in Engeström, 2001) developed the second-generation activity theory, where the actions of an individual are seen as embedded within an activity system that includes the subject (e.g. individual), the object of action, and the community being engaged in the collective action. He asserts that human actions make sense only when seen in the context of collective activity, where different actors take on different roles based upon a division of labor mediated by rules and artifacts, comprising one mediating triangle.

Engeström (1987) employed the elaborated set of triangles within the mediating triangle, building upon Leontiev’s work, illustrated as a set of triangles expanding the mediation triangle to comprise what he calls an activity system. The activity system integrates the subject, the objects and the mediating artefacts into a unified whole as a collective formation that has a complex meditational structure as the foundational unit of analyses (Engeström, 2008, p.5), illustrated by two interacting activity system in Figure 3.3, useful as a tool to analyze change and transformation (ibid.)

As Engeström (2008, p.229) explains in what he terms the third generation of Cultural and Historical Activity Theory (CHAT) “the triangular model of an activity system is a functioning tool for the analysis of teams and organizations”. It helps understand dialogue, multiple perspectives, and networking between activity systems and constitutes a model for understanding activity as collective action between two or more mediational triangles, or activity systems (Engeström, 1987, 2001).

Activity theory is a theory of object-driven activity or intervention. Objects are concerns or challenges that are generators and the foci for attention, motivation, effort and meaning. The object of the activity, the oval representation identified as object 3 (Figure 3.2, indicates the object-orientated actions “characterized by ambiguity, surprise, interpretation, sense making and potential for change”, according to Engeström (2001, p, 134). In divided terrains of activity and activity systems, multiple competing ideas often emerge and collide as potential candidates for the new concept, or object of activity. Formation of concepts is according to Vygotsky (1987, in Avis, 2010), a creative meeting between everyday concepts and scientific concepts.


In the following, some core principles of the third generation of CHAT will be explained, as they have been instrumental as tools in the analyses, Chapter 7, 8, 9, and 10.

The principles of third generation of CHAT

The first principle is that one collective artefact-mediated and object-orientated activity system, here The school community, is seen in its network of relations to another activity system, The traditional community, is taken as the prime unit of analysis (Engeström 2001, p. 136).

The second principle is the multi-voicedness of activity systems, the inclusion and collaboration between a diverse range of actors within the system. The division of labor, see Figure 3.3, in an activity creates different positions for participants. That includes different positions and hierarchies and may therefore give rise to various tensions, contradictions and conflicts in how they perceive the object. The participants also carry their own diverse histories, and the activity system itself carries multiple layers and strands of history recognized by its mediating artefacts, internal rules and conventions, as can be reflected in the tension between e.g. IKS versus formal schooling and its focus on Western and cognitive knowledge.

The third principle is what Engeström (2001) terms historicity of activity, past, now and future. The concern with “historicity” reflects how activity systems take shape and get transformed over lengthy periods. History itself needs to be studied as local history of the activity and its objects, and as history of the theoretical ideas and tools that have shaped the activity. Such historical and cultural analysis needs to focus on units of manageable size, basically focusing on the specific context in which the collective activity systems are taken as the unit, in order to be manageable (ibid). The literature review, Chapter 1 and 2, has given a brief background providing historical and cultural understanding of the context, which in this case is crucial in order to grasp and understand the HIV/AIDS discourses and their implication for prevention of HIV/AIDS in Zambia.

The fourth principle of activity theory is the central role of contradiction as sources of change and development, reflected through diverse world-views as potential driving forces of change. Contradictions are not the same as problems or conflicts but historically accumulating structural tensions within and between activity systems. For instance, when an activity system adopts a new element from the outside, e.g. scientific knowledge, or new ways of working it often leads to a secondary contradiction where some old elements, e.g. spiritual believes or traditional gender roles to mention just a few, collide with the new ones. Such contradictions generate disturbances and conflicts, but may also lead also innovative attempts to change the activity. Expansive learning then is the dialectical resolution of contradictions leading to transformative resolutions of development of the activity system in play.


The contradictions of an activity system are aggravated when some individual participants begin to question and contest the ongoing activities and deviate from its established norms. It emerges from processes of questioning, where participants in an activity system or cluster of systems question current practices, ultimately moving beyond these to generate new conceptualizations and forms of practice. As Engeström (2001, p.151) explains, “A crucial triggering action in the expansive learning process, (is) the questioning of the existing standard practice.” This is also supported by Gyekye (1997) arguing that cultural change may occur when the next generation critically question existing practices or traditions.

A full cycle of expansive transformation according to Engeström (1987, p,174,) “is the distance between the present day everyday actions of the individuals and the historically new form of the societal activity that can be collectively generated as a solution to the double bind potential embedded in the everyday actions”. The double bind potential is illustrated as different optional solutions to the object of activity. In a multi-organizational divided terrain where the unit of analysis consists of two interacting activity systems having a partially shared object, the setting may require that expansive learning actions also can be reformulated as boundary-crossing actions. “Boundary crossing occurs because human beings are involved in multiple activities and have to move between them” (Engeström, 2008, p.14). A typical example is the school student, moving from home to school to peer culture and back home, exposed to different, even oppositional, experiences or stimuli. Boundary crossing thereby provides material for double bound, or stimulation, which requires negotiation and re-orchestration, by the individuals or organizations involved, being the most obvious aspect of the horizontal or sideways dimension of development (ibid.). In some cases, these contradictions escalate into collaborative envisioning and as deliberate collective change effort.

The last and fifth principle is focusing on the outcome of the expansive learning cycle and illustrating possible forms of transformation in activity. AS Engeström (2001) explains, the expansive transformation is accomplished when the object and motive of the activity are reconceptualized to embrace a radically wider horizon of possibilities than in the previous mode of the activity.

Before elaborating on the differentiation and types of contradictions emerging during these transformation processes, a brief description of the cyclical model of expansive learning, as illustrated in Figure 3.3, will be described.

Expansive learning takes place through concept formation vertical and horizontal dimension within and between the interacting activity systems. It starts with partnerships between actors and institutions working towards a potential shared object that historically has developed with contradictory motives, tools and divisions of labor (Ellis, et al 2010, p.102). These new objects take shape as renegotiation and reorganization of collaborative relations and practices occur. This cyclic model “begins with individual subjects questioning the ongoing and/or accepted practice, and gradually expands into a collective movement or


of change” (Cole and Engeström, 1993, p. 8). The contradictions serve to both point towards the attempted resolution of contradiction within the activity systems and to wider systemic contradictions, and are therefore central to the analysis. Engeström (1987) has classified the different types of contradictions to activity systems by deconstructing and differentiating them based on how they emerge. This helps us understand how and why innovative interventions may occur (Turner and Turner, 2007, p.3). It also enables us to understand where and why the bottlenecks occur, that hinder the implementation of the actual innovation.

Expansive learning is embedded in transformations in activity systems where the learning is a result of collective creation of new objects and patterns of activity. The process is what Engeström (1987) refers to as a collective zone of proximal developing, an extension of Vygotsky’s definition related to individual development. Expansive learning is characterized by actions where the participants generate a new object of activity that is radically broader in terms of social space, relationships and participation.

Classification of contradictions

Contradictions within and between activity systems, the primary drivers of change and especially of ‘expansive transformations’, can be divided into four categories (Engeström 1987, p.82): a primary contradiction found within each constituent element, within, e.g. the mediation artefact, or division of labor in one of the activity systems, see Figure 3.4. The secondary contradictions are found between elements within or between the activity system causing dis-turbances. The tertiary contradictions illustrate disturbances between the object of an activity system and the new object of a ‘culturally more advanced’ form of the activity, and lastly, a quaternary contradiction may emerge between the actual activity system at stake and other activity systems to which it is linked. Turner and Turner (2007) provide an illustration that may help us understand the impacts of this classification in developmental work context.

Being able to identify the contradictions in any development process helps us to understand the processes, the challenges and also possible reasons for the disturbances caused by certain activities. A thorough examination of these processes will also provide the actors with new knowledge allowing them to do further in depth analyses of the contextual conditions causing the disturbances. To contextualize this within the study at scrutiny, some examples will follow.

The primary contradictions to be found within one element of the activity system is an issue that might come up, linked to the Zambian educational policy, moving from a centralized and top down administrative system, to a decentralized, which requires a certain degree of autonomous practice at the lower levels, whereas the senior administrative staff are expected to delegate. Secondary contradictions are those appearing between the corners within one


activities where the immediately appearing objects and outcomes of the central activity are embedded (object-activities), the activities that produce the key instruments for the central activity (instrument-producing activities). They include activities like education and schooling of the subjects of the central activity (subject-producing activities) and they may include activities like administration and legislation (rule-producing activities).

Different types of contradictions emerge in different ways; are contextual and situated within the existing group of participants’ worldviews, imagination, innovativeness and their ability to see solutions. Wentworth (1980, in Cole, 1996, p.142), says that, “the context is the world as realized through interaction and the most immediate frame of reference for mutually engaged actors. The context may be thought of as a situation and time bounded arena for human activity. It is a unit of culture”. This notion of context also recognizes the power of social institutions relative to individuals and the potential of individuals to change the environments that condition their lives (Cole 1996, p. 142).

The power of individuals, of institutions, and the legitimation of different epistemologies and worldviews are not clear within the various HIV/AIDS discourses as has been discussed so far in this part of the theses. The issue of power therefore needs to be addressed. The following section explains how the power dimension will be integrated in the conceptual framework in the findings and analyses.

Adapting CHAT by applying the theory of “Symbolic Power”

Engeström (1987) utilizes a Marxist perspective as his overall philosophical and theoretical paradigms. He argues that the primary contradiction lives as the inner conflict between exchange value and use value within each corner of the triangle of activity (ibid.), focusing on the commodification of the outcomes of the activities. This may stem from the fact that most of the research being conducted using CHAT, focuses on studies related to change and transformation in health or educational institutions conducted in post-industrial contexts, mainly in the so-called global north or post industrial countries.

The Zambian context, however, (Gersham, 1997; Taarn, 2003; GTZ, 2004) with its traditional leadership structure and the role of the chiefs and the HM/W executing their power in parallel to the public governing bodies at the district, community and village level reflects a post-colonial society with roots in traditionalism. The traditional leaders have their inherited ancestral and spiritual power legitimized in the Zambian constitution and regulated by The House of Chiefs as in the Zambian society today. Considering the everyday life of the majority of Zambians, specifically in semi- rural and rural areas, most people have strong affiliations to their origins in their home villages where they have their ancestors, where they were socialized and take part in the traditional cultural ceremonies. Many families may as well have a piece of land or a house in their


home village to use for their retirement. When considering the cultural and historical roots of the country, and the focus of the study, the primary contradictions dominating the HIV/AIDS discourses in Zambia, is not to be found in the economic field, as reflected in Engeström’s identification of the primary contradiction, but rather to be found within what Bernstein (2001) calls, the symbolic field.

I will further explain how Bernstein ‘s (2001) theory of symbolic power can complement the use of CHAT by replacing the economic dimension as the core contradiction (Engeström, 1987) with the symbolic control, as developed by Bernstain (2001). Using his concept of symbolic control illustrates how symbolic power can be addressed as an important factor when analyzing the processes affecting the negotiations and outcomes of an expansive learning cycle.

Viewing learning as collective action and practice also explains how situated learning is related to power. What is viewed as legitimate knowledge determine what is perceived as the dominant discourses in a given context. Power according to Contu and Willmot’s (2003) also relate to a matter of access to or an impediment to knowledge acquisition and certain learning practices. Power relations, they argue, mediate the acquisition, maintenance and transformation of meanings, including what is deemed ‘legitimate’. In this way, they state, the processes of learning, identity formation, and transformation with regard to class and gender operate to render large segments of the population of any society unable or disinclined to participate in certain communities. In that way only some privileged groups have access to spaces where meaning making is taking place (ibid., p.6).

According to Bernstein (2001) the agents of symbolic control are recognized by how they specialize in the dominant discursive codes that shape and legitimate “ways of thinking, ways of relating, ways of feeling, forms of innovation and so specialize and distribute forms of consciousness, dispositions and desires” (ibid., p.24). Those regulating the means, contexts and possibilities of discursive resources are the dominant agents in the field of symbolic control, he argues. Bernstein defines symbolic control as “both normalizing or disturbing, reproductive or productive, consensual or conflicting”… (the means)... “whereby consciousness, dispositions and desire are shaped and distributed through forms of communication which relay and legitimate distribution of power and cultural categories” (ibid. p. 23).

Bernstein further argues that social relation through which cultural reproduction and production takes place also is a pedagogical relation. The discourse following this argument, relates to pedagogic practice and acquisition, and to the distribution of power and principle of control, processes which speak through and constrain these processes and discourses. According to Daniels (2012, p.5) pedagogy may then be thought of as a sustained process “whereby somebody(s) acquires new forms or develops existing forms of conduct, knowledge, practice and criteria, from somebody(s) or something deemed to be an appropriate provider and evaluator.”


The way Bernstein emphasizes an understanding of how institutional relations of power and control can translate into principles of communication and how these differently regulate forms of consciousness (Daniels 2012.p.11) is highly relevant and useful in the context of this research. The underlying cultural norms and practices impacting the process of expansive learning leading, change and transformation in the field of HIV/AIDS prevention has historical and cultural roots. The chiefs and their parliament including HM/W, for example, historically carried mythical power and led by example (Hatt, 2004). The chiefs’ formal legitimacy and agency through their formal structure have a historically spiritual (or mythical) legitimacy, being custodians of tradition and culture, epistemologically aligned with IKS.

Their role in the community may compliment, but also potentially contradict the responsibilities of the MOE employees, members of parliament, officials at national, province, district and local level, all core actors in the national and public education structure. The link between MOE’s implementation of HIV/AIDS education prevention and the overall global UNAIDS strategies through NAC, illustrated how international agendas directly impacts national level implementation strategies and therefore also impacts local level initiatives. The impacts of UNAIDS framework on local implementation of HIV/AIDS education prevention will be addressed when analyzing different approaches to HIV/AIDS education prevention.

Bernstein’s (2003) theory of symbolic power will be used to complement Engeström’s third generation of CHAT as a tool when analyzing the processes of change and transformation in Southern Province, Zambia. It may also be useful, before moving into part three in this study, to address some critical comments to CHAT, specifically related to the fact that the power dimension is absent and basically not problematized.

Power and CHAT While Engeström has a Vygotskian root, focusing on the outcome of the activity, as Bernstein (1993, in Daniels, 2012, p. 11) argues, Engeström does not analyze, the context of the discourses. That is, he does not acknowledge the influence of the rules, community and division of labor which regulate the activity in which subjects are positioned. The third generation of CHAT tends to focus on what is said, the dialogue and interactions. The analyses thereby exclude the contextual structures of power and their discursive regulation; aspects necessary to analyze in order to understand the interaction resulting in change and transformation. Daniels further argues that “In order to understand pedagogic discourses as a social and historical construction, attention must be directed to the regulation of its structure, the social relations of its production and the various forms of its re-contextualizing as practice” (ibid. p.12). This illustrates the importance of not only analyzing the words, the micro level interactions, but a need also to understand the structural and cultural power dimensions at stake when analyzing


the processes causing the contradictions as well as the negotiations resulting in new solutions to the object of activity, to transformation.

Blackler & McDonald (2000, in Engeström 2004) have also commented on the weak treatment of power in activity theory, where Engeström admits the the lack of in-depth analyzes of authority (ibid). But according to Engeström (2008) it is not easy to depict and analyze hierarchical power relations within a single activity system but he argues that the third-generation activity theory may contribute to new ways of looking into power as it opens up for several activity systems to interact in a broader interplay (ibid.).

The historical and cultural analyses of the Zambian society in the context of HIV/AIDS clearly show how power is unevenly distributed. This is specifically relevant in regards to gender, sexuality and cultural traditions and practices as described in Chapter 5 and the role of the traditional leaders, Chapter 6. This will be further explored in the findings and analyses, Chapter 7, 8, 9 and 10.

3.9 Summary This chapter has developed a conceptual framework for examining the central issue of how HIV/AIDS education may best be mediated within the Zambian context. Structural, cultural and constructivist rationales have been examined and the critical concepts in Cultural Historical Activity Theory (CHAT). It is proposed that modern phenomena intruding into the life-space of societies in the global South are best examined using a holistic bio-ecological model of development, an approach that encompasses the structural, cultural and constructivist paradigms outlined in the chapter. The concepts of culture and world-view have been explored in more depth as the ‘software of our minds’ is a crucial tool for understanding how societies work. In the African society under discussion the concept of ‘ubuntu’ is identified as a key theme in this endeavor. Value systems were also explored in the chapter; Western and African models were compared. The dangers inherent in such polarization are noted as are alternative conceptualizations of learning and communication.

Vygotsky’s mediation concept wasexamined in some detail and its relationship to formal school explored. Returning to Engestrom’s CHAT model the chapter concludes with an attempt to apply the ‘cycle of expansive learning’ to the Zambian reality. The conceptual framework for the whole study is therefore located firmly in a battery of related theoretical concepts that help shed light on the deeper dynamics of change and potential barriers to change within a society such as Zambia.

In the following, the study focuses on the theoretical and methodolodical issues, indicating the design and tools used to respond to the research questions.

Chapter 4

Research Methodology

This chapter presents the methodology adopted for this study. The chapter starts with a brief description of the project tasks being conducted while the researcher was taking part in different HIV/AIDS preventive interventions and project activities between 2002 and 2008. It futher describes the core project work and the research activities, as well as the data and documentation being used in the research. The researcher spent approximately three months in Zambia during the first 2 years of the intervention period, reduced to two months the following two years, while working as an educational advisor to MOE, taking part in the implementation of MOE’s HIV/AIDS education prevention while applying it to meet the needs in Southern Province. The dual position as advisor and researcher during the research process is also reflected upon as well as the ethical considerations. The second part focuses on the qualitative research approach, describes the methods and techniques applied in sampling data, Moreover the chapter explains the overall constructivist grounded theoretical research approaches, the use of computer assisted assisted qualitative data analyses in processing and categorizing data, and the application of CHAT. Lastly the chapter discusses validity, reliability, and raises limitations and ethical considerations.

4.1 Background and personal context of the research. BESSIP were introduced in selected provinces in Zambia including Southern Province where I had supported the teacher-training college in developing their HIV/AIDS prevention strategy applied in the college and implemented through the student teachers under supervision of the college tutors in selected schools in the neighboring districts, from 2000 to 2002. One influential DEO was directly involved in the HIV/AIDS teacher training program at college and school level. When my involvement in that program ended, she kept me on as an advisor to support the province in the development and implementation of the HIV/AIDS


education strategy that from 2002/3 became a compulsory topic in grades 1-9 according to BESSIP (MOE, 2001, 2003).

The HIV/AIDS education prevention intervention under scrutiny research started as a pilot in two districts in 2002/3, one semi-urban with a prevalence rate of 18 percent and one rural district with an infection rate at 10 percent. After the first piloting year, the provincial level extended the HIV/AIDS intervention to include all eleven districts in the province. It comprised approximately 850 public primary schools.

The HIV/AIDS prevention education was one component in BESSIP, implemented and funded by MOE in line with basic education activities as such and decentralized to province and district level, according to BESSIP, where the implementation were following the existing ministerial routines, procedures, and reporting systems. A coordination committee, or team, for HIV/AIDS prevention education was being established late fall 2002, comprising the head senior social and counseling advisor and the educational planning officer at the province level, one head teacher, the principal of the teacher training college and the researcher. My role was to take part in the planning and development of the application of the HIV/AIDS prevention education (MOE, 2003) as a member of this core team, and also serving as a technical advisor on a short-term basis. The work of the committee had one main focus area: to support the province in developing and implementing a relevant HIV/AIDS prevention education strategy within the framework of BESSIP, according to the HIV/AIDS guidelines, using existing MOE structures and employees.

I worked closely with the core team. We jointly developed the various strategies and activities, developed the tools needed to map the ongoing HIV/AIDS prevention strategies, arranged seminars, arranged and attended meetings with relevant actors, and conducted several field visits to DEOs and a huge number of schools over the intervention period. With the lenghty hours in the car, spending days out in the fields, the core team had a lot of time to share and discuss inputs from the various activities, meetings with principals, teachers, parents and pupils, as well as traditional leaders, the chiefs and their head men, further elaborated on in Chapter 6.

The team gradually felt the need to develop an application manual, where details related to the what and how and why, were guiding the program used for district application, and a framework for local district application were also discussed and shared, illustrated by squares in Figure 4.1. In order to also follow up the interventions in the various schools and districts, the team also developed a monitoring tool, used by the HIV/AIDS Focal Point Person (FFP) in each district to monitor the schools and share the type of and outcome of the interventions with the team. These annual monitoring meetings are indicated as triangles in Figure 4.1

The research is based upon data gathered during the development and implementation of the BESSIP HIV/AIDS prevention education component as it evolved from the inception, 2002 until 2008 to meet the contextual and realities

Research Methodology 85

in Southern Province. As an educational advisor and researcher, I was viewed as a colleague and friend, referred to as “sister” by the steering committee members and other collaborating Zambian partners. While also working with highly committed professionals, representatives from NGOs and academics over a period of 5-6 years, this experience turned into a long learning process from day one, a journey supported by and with good friends.

The HIV/AIDS education intervention

To prepare the development and implementation of the HIV/AIDS prevention education, a thourough mapping of exsiting and ongoing HIV/AIDS intervention was being done before the actual launch of the intervention. The findings guided our work and enabled us to respond to the local needs when bringing our findings and ideas to the table. The outcomes of the mapping activities can be seen in Chapter 7.

The actual inception of the HIV/AIDS prevention education intervention was launched and took place during a three days planning workshop early 2003 where a diverse and broad variation of actors were sampled and invited. Those invited had a formal or informal stake in HIV/AIDS education and preventive actions and represented equally both activity systems described previously, the school community as well as the traditional community. The overall aim of the workshop was to share information, learn from peoples’ various experiences, explore where there might be some common ground, etc and reach to a common vision of how HIV/AIDS prevention could be developed and implemented within the framework of BESSIP and in the context of Southern Province. The idea was to utilize all possible material and/or human resources, identify relevant and innovative prevention strategies and create synergy between the various activities and actors where possible through collaborative action.

Approximately 100 participants were selected for the launch and inception of the project, the first HIV/AIDS workshop in its kind in Zambia. The District Education Board Secretary (DEBS), the leader of the BESSIP pilot district and the principal of the teacher training college identified the participants to be invited jointly with the external advisor, hereafter called the researcher. A purposeful, maximum variation sampling was used to ensure diversity including members from MOE headquarters, province and district MOE level representatives, including the HIV/AIDS FPP at each level. In addition, principals, teachers, parents, mostly PTA members and pupils as well as college staff and student teachers were present. The two most influential traditional leaders, hereafter called Chiefs, attended with some of their headmen (HM), the Major and members of parliament (MP) as well as relevant NGOs and Church representatives, in addition to People Living with HIV/AIDS represented relevant actors outside the education sector.


application strategies. The second seminar included capacity building of principals and two senior teachers from each school, including traditional leaders at the community level. It focused on the overall working principles, the participatory approach and community involvement, scientific and local aspects of HIV/AIDS, transmission, impacts, and the concepts reflected in the local culture and language including introduction and training according to the HIV/AIDS Application Manual1 (Appendix F).

The third capacity building activity illustrated by the rectangle in Figure 7.1 is the school and community-based activities targeting the local actors, addressing and identifying their local challenges related to HIV/AIDS education prevention, issues that later on were reflected in the diverse approaches and interventions developed in the different districts and schools, including implementation strategies and responsibilities. The capacity building of teachers were an important part, where through school-based workshops were trained in using the pedagogical methodologies and strategies reflected in The Interactive Methodology for HIV/AIDS (MOE, 2003a).

The annual monitoring and evaluation sessions are also reflected in Figure 4.1. A common set of monitoring and evaluation tools were based upon the indicators the different stakeholders2 found relevant to monitor the HIV/AIDS activities. The annual sessions turned out to be valuable spaces for sharing, reflection and horizontal learning among the different stakeholders, identifying best practices at school and community levels, indicate the impact of the epidemic on school attendance, number of infected teachers going for ART, number of orphans etc., and were tied to the implementation strategies (Appendix G). As illustrated in Figure 4.1, the monitoring and evaluation sessions grew bigger as the implementation expanded into new districts that gradually were included in the project.

The localized HIV/AIDS prevention developed, termed Interactive School- and Community Approach (ISACA), was guided by the following principles: broad stakeholder involvement in all stages of the program, including the planning phase and facilitation through empowering strategies. The group work started with homogenous participants, thereafter followed by heterogeneous group work across gender and status, through participatory and interactive methods, which fostered the raising of topics and concerns that were motivated by and reflected the local needs. The overall outcome was horizontal and vertical sharing within and across traditional borders or barriers, illustrated by the sharing between HIV/AIDS FPP at different schools or districts, or relations between different levels within MOE and the traditional leadership structures. 1 Developed, piloted and approved by the project coordination team based upon the

first pilot experiences, important also for sharing, reflections and learning through ongoing revisions.

2 Reviewd by staff at province, district and school level.


The innovations and interventions occurred at different levels, e.g. province, district, school and community levels, involved a multiple range of actors, as indicated above, and were iterative in nature. It was initiated by representatives from the educational sector, but as the HIV/AIDS epidemic impacted the lives of everyone in a context were people and families where either “infected or impacted”, people were highly motivated and engaged.

The core interventions took place within and across the two different governing structures, one being the traditional leadership structure, the activity system termed The Traditional Community. The other interacting activity system is the educational structure, including the school-community relationship, in the following called The School Community. The interventions or activities either were of vertical character, between the various levels within each of the activity systems, or conducted across the activity systems as horizontal and cross-sectoral partnership. These activities took place at district, school and community-levels including NGOs and CBO where relevant.

4.2 Dual role, advisor and researcher Serving as the foreign technical advisor (FTA), from 2002 to 2006 made it easy to get access to the different sites, to relevant policy documents and being exposed to a broad diversity of respondents and informants, through formal and informal settings. The HIV/AIDS prevention education was an integral part of MOEs education policy, and all activities and interventions, including those that took place when I was in Norway were documented through minutes and reports, shared and reflected about among the core project team members during my next visit. The systematic way the core team used, to build the interventions upon the data gathered from the different activities in order to applying to an iterative implementation strategy created a huge source of information.

After being involved in this work over a couple of years, I decided to use the data for research purposes. The rich source of data was then organized and systematized for the research purpose, and as the interventions scaled up, new data were gathered. Theory informed practice and practice refined theory in a continuous transformation during the research process. Although the province education officer approved that the data could be utilized for research purposes most of the respondents did not know my dual role and the research method thus resembles covert, through participatory observation (Bryman, 2008).

Given the limited time and resources available, it was necessary to merge research and advisory topics and overlap as much as possible in order to organize data collection to support both areas. The two processes overlapped. The two roles I played as advisor and researcher will be described and divided between Macro/Exo level analyses and Meso/Micro level analyses. The socio-political and historical level analyses, at Macro/Exo level, focused on educational and HIV/AIDS policies and strategies, including the impacts of global HIV/AIDS


prevention strategies on the implementation of HIV/AIDS education prevention in Southern Province. These were particularly relevant as a source of data and information needed as an advisor to MOE and HIV/AIDS prevention.

It may not be easy to draw a distinct line between my advisory activities and my research activities, but Figure 4.2 aims at giving an overview. Each of the columns, one labeled macro/exo level- and the other micro/local level analyses, are again divided in two. Some rows indicate analyses that are overlapping, addressing analyses that were equally necessary in order to conduct the advisory as well as the research activities,

As the development and implementation of the HIV/AIDS education prevention strategies were located in different districts and communities, the participatory processes and the interactive aspect of learning and transformation at school and community levels were equally important to invesitage the contextual diversities at Meso and Micro levels. The capacity building of district-, school-, and community-level was a major component to support the implementation of the HIV/AIDS prevention education in Southern Province. However, as indicated in the boxes in4.2, the core focus of the research was to address the voices of the diverse group of actors involved in the project, emphasizing processes, how they perceived the issues addressed and found their own local solution, based upon dialogue and negotiations which is also reflected in the research questions.

The Macro/Exo level analyses mainly explore the national HIV/AIDS policies and the impact of UNAIDS global strategies through NAC on the execution and implementation of the Zambian HIV/AIDS prevention education. Whereas the Meso/Micro level analyses address and explore the views of the various stakeholders and respondents at district, school and community levels during the development and implementation of the interventions under study.

4.3 Overall research approach. The research activities were undertaken in the 11 districts in Southern Province in Zambia focusing on how HIV/AIDS prevention education was applied to and implemented in the province. This case study relied on multiple sources of evidence through constant comparisons between districts and schools in the province, and their implementation strategies and innovations. As Yin (2009) explains, case study research can mean single and/or multiple case studies. An empirical inquiry that investigates a phenomenon within its real-life context. Case study research can mean single and multiple case studies, can include quantitative and qualitative evidence, and explores a program and a process in depth, according to Creswell (2009).


The researcher collected data over a period of approximately six years, utilizing a longitudinal research approach. Through descriptive and explanatory analyses, the study explores causation, searching underlying processes or principles. Detailed information and data were collected through a variety of data collection procedures, including a mix of quantitative and qualitative sources. Although the study primarily uses qualitative data, some quantitative data is used to illustrate contextual conditions. The case study also relies on multiple sources of evidence, and benefits from the prior development of theoretical propositions as explained by Yin (2009) and Creswell (2009). One of the advantages of this approach according to Bryman (2008) is the close collaboration between the researcher and the participants or respondents that enable them to tell their stories and describe their views of reality to help the researcher understand the participants’ actions.

What a researcher views as the nature of reality frames the research, whether the study is of objective or constructed realities. Bryman (2008, p. 21) states that “Ontological assumptions and commitments will feed into the ways in which the research is carried out”. A case study is based upon a constructivist paradigm, built upon the premise of a social construction of reality (Yin, 2009). A constructivist view of reality implies that individuals are not divorced from social actors, but are social constructions. Instead of viewing reality as objective, it is here viewed as socially constructed through ongoing interaction with the environment and other humans (Berger and Luckman, 1967) and is therefore constantly changing. Social phenomena are not independent of social actors, but are actively constructed by individuals and groups (Bryman, 2008, p.22).

The data was extracted from communities and schools in 11 different districts, and explored a range of settings, helpful in identifying the significance of context and the ways in which it influences behavior and ways of thinking, according to Bryman (2008). In the following, the details about the sampling procedures are described.

4.4 Sampling of data and sources of information

Research period

The researcher/educational expert was involved in the school mapping excersise jointly with the tutors at a teacher training college during 2002, and was associated with members of the ISACA project coordination team from its very beginning. The researcher had two visits to Southern Province each year after the inception of ISACA, each lasting for a period of approximately 3 weeks, usually during February, after approval of the annual budget and activity plans, and when also the joint monitoring and evaluation meetings were conducted. During the fall visit, usually the launch, introduction and application to new


districts took place, followed by training and capacity building activities. Annual dates for the project visits: February and November (2002), February and November (2003), February and September (2004), February and September (2005) and lastly September (2006).

During the researcher’s many field visits to Zambia, the coordination team also conducted meetings with districts representatives, did a number of school visits to rural as well as urban schools. Usually 4-5 schools were visited during each period. These field visits included meetings with principals, teachers, PTAs and FPP for HIV/AIDS, (after cohort 2, that responsibility was given to the guiding and counseling officer or teacher but with the last cohort the Human Resource officer was in charge).

The field visits also allowed me to meet with the chiefs and their parliament members, HM/W when available. They were invited and included in the core planning workshops and attended various capacity building sessions at district level, and applied their knowledge of governing their kingdoms. Sometimes the coordination team was requested to come and see what had happened in their kingdoms, in other instances, we asked if we could come and visit them, or met them occasionally at schools.

The project coordination team assessed the progress and impact of the various activities and handed reports back to the Provincial Board by the end of each Zambian visit and made plans for the up-coming annual program activities. An overview of the main research activities and other types of data are listed in Table 4.1.

As can be seen from Table 4.1, school mapping was done in 2002 whereas the HIV/AIDS intervention, ISACA started in 2003 and I finalized my direct involvement in the various activities after the 4th cohort were included in 2006. The researcher also had a visit to the research site in 2008, and was able to follow up with the two core members of the ISACA coordination team, and in addition having a meeting with one of the DEBS highly involved in the project.

The data categorized in the 4 coloums Table 4.1 consists of policy documents, surveys, field notes and reports and minutes. Most of the documents were handed over as paper copies1, later on some came as soft copies, as also was the case with minutes and other type of internal reports. The surveys and field notes were handwritten, thereafter transcribed. As is further explained most of the data were uploaded and utilized in a computer assisted qualitative data analyses software. In the following, there is a brief description of the types of data and the data gathering proceduers.

1 Available in my office


Table 4.1 Types of research data collected by year

Year Policy/ Documents

Surveys Field Notes Reports/ Minutes

1998 Education policy, Educating our future (1996)

2002 HIV/AIDS syllabus, manuals and guidelines Syllabus (2002) BESSIP (2002)

School mapping (2002)

Planning workshops

Planning workshops

2003-2006

Interactive methodology for HIV/AIDS (2003)

Structured open-ended questionnaires to principals, PTA members and teachers (2004)

Launch, district planning workshop Monitoring and evaluation workshops In-service training activities Field visits

Launch, district planning workshop Monitoring and evaluation workshops In-service training activities

2002-2006

HIV/AIDS documents (I/NGOs), Literature reviews

Informal project coordinating team meetings, reflection notes

Project and district reports

2008

Revisit to two districts cohort 1

School mapping activities In order to get an overview and insights of the ongoing HIV/AIDS interventions, used to inform the development of the HIV/AIDS strategy by assessing views and experiences and the actual context from the various informants at school and community level a school-mapping exercise was conducted.

The survey had a cross-sectional design and it was done at a single point in time, during spring 2002. It included qualitative as well as quantitative data, all principles characterizing survey research according to Bryman (2008, p.46). The school survey tools (Appendix X, Y, Z) were developed and designed at an internal workshop at one of the teacher training colleges jointly by the researcher and lecturers. The tools should be easy to use for the college lecturers, as the


surveys were conducted while they were visiting and supervising their own student teachers during their practical teaching period, convenience sampling of multiple cases, e.g. schools. The compilation of findings was done in close collaboration with the lecturers at the teacher training college.

Qualitative data comprised information from 16 schools during the so-called outreach activities on HIV/AIDS prevention and sensitization, conducted by selected teacher college tutors. The data was collected through interviews with school principals focusing on the type of HIV/AIDS teaching materials and explorations on to what extent HIV/AIDS prevention activities were a part of their school-policies on HIV/AIDS, if and how HIV/AIDS preventions was implemented and the involvement of PTA members. Parents and pupils were also contacted through informal dialogues during these sessions.

Two meetings with groups of principals were conducted comprising respectively 8 and 12 participants from the pilot districts in 2002, where they shared their views on HIV/AIDS prevention education and the role of the schools in that regards. Another survey of the content of the existing HIV/AIDS teaching materials in the library of an urban school in Livingstone, grade 1-9 is also a part of the baseline. In addition, quantitative data were collected in another 50 schools, where the lecturers then registered types and numbers of HIV/AIDS teaching materials.

Documentary review Reviewing national guidelines for HIV/AIDS education, as well as literature reviews, from international and national agencies as well as research in the area of HIV/AIDS education and impacts, preventive means, experiences from intervention within and outside Zambia etc., was an ongoing activity during 2002-2006 as also referred to in previous chapters. The documents referred to in the overview above relates to national education policy documents and HIV/AIDS guidelines, all of which we had to base our HIV/AIDS strategies on.

Open ended questionnaires In order to assess some preliminary outcome of the capacity building and HIV/AIDS prevention education activities, questionnaires were submitted targeting cohort 1, aimed at getting the respondents’ views upon the process, outcomes possible challenges and barriers when using the Interactive Methodology on HIV/AIDS. Principals (11), PTA members (9) and teachers (22 from two different schools) were involved in the survey in 2004. The selection was based upon convenience sampling, e.g. they were all available to the researcher by virtue of accessibility (Bryman, 2008, p.183). They all were attending a specific workshop where the topic focused on the challenges for the growing number of orphans and vulnerable children. In the open self-completion questionnaire, the respondents replied however they wished, it was anonymous,


and it was used in order to understand and explore how the different groups assessed the intervention (Bryman, 2008, p.232), here, the implementation of HIV/AIDS education. The research tools is attached as Appendix I, A-D and J.

Field notes The field notes were in the form of hand written notes1 taken during all the ISACA interventions and activities where the researcher was present. There were observations from the big events, such as the planning workshops, the monitoring and evaluation workshop and the in-service training activities. Field notes were also the means for data collection during the school visits, to the chiefs’ castles and parliaments, as well as other meetings at province and district education offices and MOE Head quarter (2005) in Lusaka. Nine note books, were systematically used for that purpose, where observations and reflections to the discussions were noted. The observations were typed by the researcher and categorized as explained later in this chapter.

Taking notes did not seem to be obtrusive to the participants nor did it create a lot of awareness as also argued by Bryman (2008, p. 419) in the case of using field notes. A recorder would be difficult as the number of participants varied, and were often taking place in noisy areas. In most instances, electricity was scarce, unreliable or not existing.

In informal coordinating team meetings, the researchers own reflections and field notes represented another important source of information as various issues were discussed and clarified. Details from meetings, visits and observation throughout the project period, from 2002 to 2006 were written down shared and discussed during hours and days with informal talks in the car during field visits.

Flip charts Many of the outcomes from the workshops included concrete suggestions and issues addressed by the various groups on flip charts during the different sessions. They were all systematically collected by the researcher and proved to be important data. The homogeneous group discussions gave valuable information on the views of the different stakeholders, and were useful documentation about ideas and proposals identified by the various actors. Similarly, the outcomes from the heterogeneous group work and discussions indicated possible solutions, innovations and contributions from the actors based upon the presentations from the homogeneous groups.

1 A total of 10 A5 handwritten notebooks were typed, they are still available.


Minutes, reports This category of data, the minutes from the different activities organized by the PEO, were taken and formalized by a secretary. That included minutes from the planning workshops, from the district application seminars and school based in-service interventions. The number and diverse stakeholders present in the different sessions were included in the minutes taken by the secretary always a part of the team when running the various program activities. These minutes were valuable inputs to the progress of the project, they were written by a third party, the secretary. These documents were useful for the purpose of triangulation, to check these minutes with my own field notes. When any of these activities were conducted while I was in Norway, they also proved to be valuable as additional data for the research.

The reports submitted from the coordination team to the Province board after the Zambian visits, also had the element of triangulation. They were the outcome of a negotiated and common understanding of the activities and inputs of the core team members. These contributed to an in-depth knowledge of the issues at hand. These data, including all other relevant printed information were imported to NVIVO, the program used to support the storing and analyses of the qualitative data.

MOE annual plans Each district reported their activity plans, their budgets and also outcomes annually to the province level as a part of the decentralized approach in BESSIP. These documents also included in detail all HIV/AIDS activities, schedules, timelines, number and type of activities and people and the budget estimates for each activity. These reports were written jointly by the team members and submitted to the coordination team, and were useful data when assessing and discussing the impact of the HIV/AIDS activities, as well as being useful as a means of triangulation.

Newspapers, newsletters Additional sources used to collect data to understand the HIV/AIDS context and the ongoing public discourses in Zambia were newspapers, newsletters developed by pupils at school level as a part of the project interventions, and any other available written sources from NGOs and other collaborating partners. Excerpts used in the findings chapter The HIV/AIDS intervention, ISACA was scaled up from the pilot in three districts, thereafter extended with three new cohorts, one cohort each year. The first cohort (c1) started the planning workshop late 2002, four new districts were included in 2004 (c2), thereafter adding another four districts in 2005 (c3) and lastly the four remaining districts in the province were included in 2006, (c4).


The various stakeholders’ contribution to the development of the ISACA through their “voices” represents the diverse perceptions in the participatory processes. Each “voice” reflects the views of different actors. They have different perspectives and thereby represent diverse solutions to the object of activity during the negotiations. In the findings chapters, the stakeholders are grouped by stakeholders, and refered to according to their category, reflecting their formal role in ISACA, although some might have carried different roles, one being a father or a mother and at the same time a teacher, principal or HM/W. By using these categories, the researcher was able to identify the specific contribution reflecting the worldviews from the diverse groups of respondents.

The various excerpts used in the findings chapters are all written in itallics to highlight the voice and contribution of the different stakeholder. These voices are referred to by identifying stakeholder and cohort. In the study, the stakeholders are identified according to the formal position they had in the project, e.g. chief, HM/W, DEO, principal, teacher, pupil etc. Field notes in the findings chapters are identified as (f.n), therefore, f.n.c1 refers to field note cohort one or f.n.c2, etc., referring to field notes from the relevant cohort.

In the following, though, the qualitative research methodology will be further elaborated on to explain how the data was processed and analysed to grasp the processes under study.

4.5 Qualitative and constructivist grounded approach According to Elliot et. al. (1999), qualitative research can include wide range of approaches such as empirical phenomenology, ethnography, qualitative discourse analysis, conversation analysis, ethnomethodology, grounded theory, narrative inquiry and social action research. These approaches have all developed their own different traditions and methods within different explicit and implicit philosophies, but as Elliot argues, “What they all have in common is that their central purpose is to contribute to a process of revision and enrichment of understanding, rather than to verify earlier conclusions or theory” (ibid., p.216).

The qualitative approach applied in this research helped me to explore and try to understand the developmental processes from a cultural historical perspective by grasping some of the underlying contradictions identified through the voices of the different stakeholders involved in the research project.

What a researcher views as the nature of reality frames the research, whether the study is of objective or constructed realities. Bryman (2008, p. 21) states that “Ontological assumptions and commitments will feed into the ways in which the research was carried out”. A case study is based upon a constructivist paradigm, built upon the premise of a social construction of reality (Yin, 2009). A constructivist view of reality implies that individuals are not divorced from social actors, but are social constructions. Instead of viewing reality as objective, it is here viewed as socially constructed through ongoing interaction with the


environment and other humans (Berger and Luckman, 1967) and is therefore constantly changing. Social phenomena are not independent of social actors, but are actively constructed by individuals and groups (Bryman, 2008, p.22).

The ontological position of constructivism implies that reality is constructed, and that the researchers’ own views of the social world can be seen as a construction. This implies that the “researcher always presents a specific version of social reality, rather than one that can be regarded as definitive” (Bryman, 2008, p. 19). There is no objective reality waiting to be discovered by the researcher.

Researchers need to gain access to people’s way of viewing the world, according to Bryman (2008). This requires openness to the experience of the subject, the respondents and informants. One of the main duties for qualitative researchers is to see the world through the eyes of the people being studied (Bryman, 2008). In a qualitative approach a detailed description of the social setting and events are important to understand social behavior and change.

Research methods are not objective or neutral tools. Research data are collected according to something, most often a theoretical framework. The present study applies an inductive research design, where context, observations and actions in the field reveal patterns and relationships through coding and categorizations emerging from the data (Bryman, 2008, Creswell, 2009). The inductive and iterative approach were applied due to the nature of the research as data was collected by going back and forth in the field over a lengthy period. The data collection process led to revisions of explanations, issues and concepts.

An on-going and constant comparison of data emerging from the various activities and observations at district, school and community levels, as well as from the documents, reports and minutes revealed new insights to be investigated by the researcher. This constant comparison of data, the inductive and iterative approach borrow key methodological elements from grounded theory, in this study the constructivist grounded theoretical approach, as developed by Charmaz (2006), has been applied. This will be further explored in the following section.

Constructivist grounded theory

The purpose of grounded theory is to explore and understand how complex phenomena occur, the nature of knowledge development and conditions affecting this development (Brown et. al., 2002). This requires a variety of sampling methods, usually a thick description of the phenomena, generating a large and complex database. The data within the database relies on data from different media such as field notes, interviews and documents, among other, also supported by Bryman (2008) arguing that “It has the attractiveness of the richness, but the difficulty of finding analytical paths through that richness” (ibid., p.538).


Charmaz (2000) offers an alternative version of grounded theory, the constructivist grounded theoretical approach, applied to in this research. She argues “that people create and maintain meaningful worlds through dialectical processes of conferring meaning on their realities and acting with them” (Bryman, 2008, p.549) generating concepts rather than theory as such. Her constructivist approach recognizes that categories, concepts and theoretical level of analyses emerge from the researcher’s interaction within the field, the actosr and respondents and questions about the data.

The constructivist approach assumes that what we take as real, as objective knowledge and truth, is based upon our perspective, where the researcher aims to explore what research participants and respondents define as real and where their definitions of reality take them. Charmaz (2000) further argues that; “The research products do not constitute the reality of the respondents’ reality. Rather, each is a rendering, one interpretation among multiple interpretations, of shared or individual reality” (p.513). A “discovered” reality arises from an interactive process where the researcher explores temporal, cultural and structural contexts. Thus, trying to interpret how subjects construct their reality within the context in which they live. This is done by including multiple voices, views, and visions that contribute to rendering lived experience.

Constructivists seek to understand meanings, both respondents’ meanings and their own. To seek respondents’ meanings, we must explore deeper than surface meanings or presumed meanings. We must look for views and values as well as for acts and facts, including beliefs and ideologies as well as situations and structures (Charmaz, 2006) all equally relevant to understand what influences the development and implementation of HIV/AIDS prevention education. The flexibility and multiple strategies offered by constructivist grounded theory enables this type of research which also allow the researcher to use concepts from other perspectives, because applicability and usefulness are parts of the criteria for data analyses according to Charmaz (2000, p. 511).

4.6 Processing the data A main difficulty with qualitative research is that it generates “a large, cumbersome database because of its reliance on prose in the form of such media as field notes, interview transcripts or documents” (Bryman, 2008, p.538). It provides richness of data, but there is difficulty in finding analytical paths through that richness (ibid). The information-rich amount of data needed to be broken down to concepts, categories or properties e.g. attributes or aspects of a category in order to explore and understand the processes at hand, to build up hypotheses or initial hunches about relationship between concepts. The findings revealed in the study comprises of a set of categories evolving from statements and written reports and documents that systematically reflects the relationships between


them that forms explanations to social or other relevant phenomenon. Such a research process is similar to what is explained in Bryman (2008, p. 544).

Coding and categories

A constructivist approach recognizes that the categories, concepts, and theoretical level of an analysis emerge from the researcher’s interactions within the field and questions about the data (Bryman, 2008). Coding, according to Charmaz (2000) keeps us thinking about what meanings we make of our data, asking ourselves questions of it, and pinpointing gaps and leads in it during subsequent data collection. These action codes give us insight into what people are doing, what is happening in the setting. Charmaz (2000, p.515).), further argues that “The constant comparative method of grounded theory means (a) comparing different people, such as their views, situations, actions, accounts, and experiences, (b) comparing data from the same individuals with themselves at different points in time, (c) comparing incident with incident, (d) comparing data with category and (e) comparing category with other categories”.

Selective or focused coding uses initial codes that reappear frequently to sort out large amounts of data. These codes account for the most data and categorize them most precisely. Categories for synthesizing and explaining data arise from the focused codes and categories shape the developing analytical framework (ibid.). Through using comparative methods, we specify the conditions under which they were linked to other categories. After deciding which categories best explain what is happening in the study, they will be treated as concepts, according to Charmaz (2000).

Open coding

What Bryman (2008) terms the “large, cumbersome database” in qualitative research, turned to be a big challenge when coding and categorizing the data. The researcher tried out different ways of categorizing the data using different matreixes and based upon different ways of organizing the data, first sorting by cohort, then by districts and lastly by stakeholder in trying to identify concepts and categories, searching for some relationships between them. Finally, the researcher did not see any other way out than trying to analyze data using a computer assisted qualitative data analyses software (CAQDAS) (ibid.). This was done, firstly in order to det an overview and store the data, and it was an effective way of organizing the different sources of data. For practical reasons, NVIVO was selected. It was available at my workplace, and there were research fellows that could support me. The various types of data was uploaded and stored into the program, from soft copies of policy-documents, minutes from meetings, transcription of field-notes, flip-charge content and inputs from questionnaires and any other relevant documentation. Using such a software removes some of


the clerical tasks associated with the manual coding and retrieving of data. The programs allow the researcher to code the text while working at the computer and to retrieve the coded text, e.g. the sequences of text to which a code or a combination of codes was attached.

The researcher interpreted the data, coded them, retrieved and categorized them, but NVIVO contributed with tools taking over the manual labor, through the use of nodes and tree-nodes and other tools further explored in this chapter. According to Bryman (2008, p.550) computer assisted qualitative data has implicitely promoted many of the grounded theoretical research processes, “because the software programs have often been written with grounded theory in mind” (ibid.).

I will in the following section elaborate on and illustrate how NVIVO was utilized describing some of the steps taken while coding and categorizing the findings by referring to the logging process applied by the researcher during the process, and also illustrate some simple query methods that guided and supported the analytical process.

Logging the codes and categories

I was logged in the Nvivo Process in order to remember what and how I proceeded with the processing of data. I started out with inporting all the sources of data in the program, e.g. documents, workshops, minutes, field notes, reports etc. in different files in NVIVO. According to Bryman (2008), constructivist grounded theorists code the data as we collect them (ibid., p. 542). By using open coding, a first process of breaking down, examining, comparing, conceptualizing and categorizing data to yield significant concepts which later were fitted in to form major categories of data. Coding in NVIVO is “the process of marking passages of text in a project’s document with nodes. Nodes are therefore a collection of references about specific themes, places, persons or other areas of interest” (ibid. p. 570). When a document has been coded, the node will incorporate reference to those portions of documents in which the code appears.

The codes were typed in full sentences as they also appeared in the field notes, in order to make it easy if using them as quotations for the final theses. The field notes, the views from principals, teachers, chiefs etc., they were all easily identified in NVIVO, using “drag and drop” creating a huge number of free nodes. I also identified some nodes that might be merged, as Bryman also say, “nodes can be changed or deleted” (ibid, p. 570).

I also indicated the nodes in order to be able to identify them by district, this allowed me to search for districts, specific attributes and characteristics or comparisons and see if there were differences or similarities. By identifying the districts using the nodes illustrated above, the characteristics of each cohort, the short and the long-term impacts, e.g. from cohort 1 and 2 might be identified. Memos or annotations were added and linked to relevant documents where


reflections or issues would add to the node as such. This also relates to links to other files, pictures or even webpages, e.g. “Hope stakeholder-input, way forward will give some examples on how the group of district representatives followed up somehow, degree of ownership?” (memo, 041206).

The open coded nodes turned later into tree nodes, made upon the free nodes into a tree-like structure. This implies the connections between them, turned into a tree of related nodes (Bryman 2008, p.570). Computers may also make the research process difficult, as in my case, the laptop did not have enough capacity, it proved to be impossible to mark, click and paste to tree nodes without getting ICT support, followed with a safe backup, in order to continue, as written in the log (051206).

Queries

NVIVO also allows the researcher to do queries, e.g. intersections between nodes, e.g. queries on stakeholder-participation and ownership, etc. It could be roles, responsibilities, entrepreneurial ideas or autonomy, decentralized or centralized leadership approaches, as well as participation and emancipation. NVIVO also have other tools, e.g. queries, as in this case was used to address e.g. voices from categories of stakeholders, by districts as suggested in field notes (18122006).

For validation purposes queries on change, identified by using data from different sources e.g., my own field notes, monitoring and evaluation outcomes, or minutes from other project meetings written down by the secretary. Other issues that were looked into were queries on cultural risks, hindrances related to the contraction of HIV/AIDS, identified by source: e.g. stakeholder and cultural and local practices enhancing the spread of HIV/AIDS, from sources, e.g. field notes and minutes from workshops.

In order to see how often the various stakeholders referred to issues related to cultural practices, e.g. taboos, misconceptions, but queries were also conducted by stakeholder, e.g. Searching for the frequency of all: “chief, HM, culture, cultural, traditions, traditional leaders”, in the field notes. Saving it as a new free node: Chiefquiery1, DEBS query (memo, 161222).

Constructing and modelling the core findings

The program also allows the user to create models, e.g. relationships between the nodes. Models were made related to some of the key categories and concepts that came out as significant findings in the study, e.g. culture and traditions. Arrows indicated linkages between the concepts based upon the frequency of linkages to and from the various nodes, and the researchers changed and tried out different connections when searching for relationships.


NVIVO was used as a tool to store the large amount of data organized by type e.g. documents or newspapers and different categories of the voices of the respondents. Additionally, I created visual models from the stored qualitative data at hand. In Figure 4.3, 4.4 and 4.5 different models are illustrated. The first model illustrates a fairly overloaded and non-structured number of categories, whereas the two following are limited to two of the main issues scrutinized in the study as the research questions gradually emerged, circulating around multivoiced collaboration, in a socio-historical context of HIV/AIDS.

The findings address these core themes as illustrated above, in relation to structure and management, in relation to cultural transformation and change and in relation to the school- and community-based application of HIV/AIDS prevention activities.

As illustrated from in the modelling of findings, Figure 4.4 and 4.5, two core categories emerged from the data, the cluster of nodes and concepts reflecting the importance of culture and tradition when running activities and working with interventions to prevent the spread of HIV/AIDS in the Zambian context. As revealed in Chapter 2, the prevention of the epidemic was in many instances related to traditional practices and beliefs. The other cluster of nodes and concepts, surrounded the HIV/AIDS education prevention interventions, related to the actual HIV/AIDS education prevention discourses, reflecting a western schientific discourse, and elements from the ISACA strategic intervention.

These two clusters of concepts emerging from different search using the modelling program options in NVIVO, were reflecting the different knowledge systems, and seemed to align with Mersteins concepts on symbolic power. These simingly contradicting perspectives on the epidemic, the spread and mitigation, had been contested among the various groups of respondents throughout the research period. In order to give an answer to the research question 2 and 3, to understand how the broad participatory approach could contribute to change by constructing a new object of activity, and further identify the impact of these interventions during the project the third generation of CHAT (Endeström, 1987, 2009) was applied as a tool for the analyses. The two activity systems, as explained in Chapter 3, The school community, interacted with The traditional community. The analyzes focused on the voices, the views and arguments from the various stakeholders involved reflected by stakeholder, e.g. chief, HM, principals, lecturers, parents and pupils, just to mention some, in order to identify how the different groups of participants contributed to the new intervention, or rather object of activity. The historical and cultural overview given in Chapter 5 and 6 will further describe the artifacts, the rules and the division of labour that characterize the traditional community. Chapter two gives an insight in the tools, the rules and the division of labour in The school community. The link between


constructivist grounded theory, CHAT and participatory approaches, pillars in this research approach, will be further elaborated in the next section.

Figure 4.3 Complex and relational HIV/AIDS discourses

This overcrowded model shows a picture of issues and actors illustrating the complex realities, networks and discourses related to HIV/AIDS education and prevention in Zambia. The model is based upon the nodes and categories stored in NVIVO program. The arrows are movable, and have been organized and clustered in 4.3 in order to identify some preliminary relationships between the tree-nodes, or categories. During the process of constructing the main categories and the core findings, there were three main issues that emerged. The first theme was related to the structure and managerial issues related to the Zambian HIV/AIDS prevention strategies, with a focus on the role of the education sector. The second theme that evolved was the emerging nodes reflecting cultural practices and traditions, illustrated in Figure 4.4. The third emerging categories related to the interactive methodology of HIV/AIDS education, as can be seen in Fgure 4.5.


Figure 4.4 Nodes reflecting cultural practices and traditions

The illustration shows nodes and tree-nodes/categories that were linked to HIV/ AIDS related to traditional cultures and practices, as indicated in the inner circle. It shows a relationship between drivers/challenges relating to HIV/AIDS and to traditional and cultural practices. This became a focus of the inquiries.

This third illustration shows the nodes/categories clustered around issues related to ISACA, its overall strategy, school and community level discourses and some impacts of the intervention.

Figure 4.5 Emerging categories based upon nodes related to HIV/AIDS prevention education


Links between constructivist grounded theory, Cultural Historical Activity Theory and Participatory approaches

The participatory methodologies applied to during the HIV/AIDS interventions was based upon collaborative inquiry, emancipatory research, and action learning, all situated in real-world contexts aiming at solving real problems and therefore applicable to variations on the same theme (O'Brien, 1998). The approach is known by many different concepts, as also reflected in Smith’s (1999) elaboration on decolonizing methodology characterized by inclusive and participatory processes applied during all the HIV/AIDS interventions. The importance of recognizing the voices and views of the people involved, and at the same time adhering to local perspectives and cultural protocols (Umemote, 2001) was possible due to the dual role I played, as advisor and researcher, and my close collaboration within the HIV/AIDS prevention education program’s coordination team.

These principles have also served as ethical codes of conduct during the research project, also characterized by Smith’s (1999) definition of “respect”, as she explains: “Respect is a shared, constantly interchanging principle which is expressed through all aspects of social conduct” (ibid., p. 120). Social research at the community level aims at generating local solutions to local problems, or searching for models seeking to make a positive difference in the conditions or lives of people. Therefore, the methodology and research methods applied are important and often the process is far more important than the outcome, she further argues, the processes applied should enable people to heal and educate. She continues, “The processes are in other words expected to lead one small step further towards self-determination” (Smith, 1999, p. 127). The processes applied in this research is characterized by participation, consultation, negotiation, collective meaning-making, open debates and shared decision-making procedures. According to Smith (1999, 2008) each of these are important aspects within an inclusive research practice paradigm.

The focus on emancipatory processes, enabling people to identify and be actively involved in finding solutions to their own problems, is the focus of this research, in order to explore how the local actors themselves viewed their world and found their own local solutions to mitigate HIVAIDS. Emancipation requires recognizing the views of all actors involved, including the indigenous people (Smith, 1999). The same approaches are also reflected in Freire’s (2000) pedagogy of the oppressed, as Collins (2011) further argues. The traditions from Freirean participatory and emancipatory processes and CHAT are both compatible and complementary. From the CHAT perspective, Freirean research traditions have special value in terms of how it links its concept of human activity to issues of politics, ideology and social justice. In this way, Freire’s contribution enables CHAT to connect its underlying emancipatory vision.

The principles of the 3rd generation of CHAT according to Engestrøm (2001, 2008) can be used either as a research methodology or as a tool for


analyzing data, as is the case in this study and explained further in Chapter 3. The complementarity of CHAT and constructivist grounded theory has been analyzed by Seaman (2008). He illustrates how the postmodern transformation of constructivist grounded theory complements CHAT and outlines some practical methods implied by the joint use of constructivist grounded theory as an approach and activity theory as a tool for analytical purposes.

Constructing or modifying a theory about “multilayered social situations,” from micro- to macro level interactions, requires that the researcher has a clear picture of the interactions of individuals and the various levels, emerging through observational techniques, where the researcher sets out to capture respondents’ views along with rich details of the local setting (Seaman, 2008, p.1-2). The context is crucial for understanding the phenomenon and to obtain the specific details of experiences (Brown et al, 2002). This coincides with Creswell’s (2009) characteristics of qualitative narrative research, beginning with a broad study to generalize the results to the given phenomenon under study. The discovered reality arises from observations and interactive processes, and its temporal, cultural and structural contexts (Charmaz, 2000).

To explain why individual interactions within the data can shape patterns requires theoretical work that does not just focus on what and how they occured (Charmaz, 2006). The researcher needs to seeks patterns across multiple collection points and data types to analyze rather than simply describe, e.g. follow hunches based on themes derived from the data, explicitly adopt sensitizing concepts or otherwise take cues from an existing theory (Seaman, 2008, p.2). Therefore, Seaman (2008) argues constructivist grounded theorists might increasingly draw on existing theories to help them understand the multilayeredness of the social situations under study. This transformation of grounded theory helps the researcher to develop explanatory theory concerning common social life patterns based on themes derived from close interpretations of empirical data (Annells, 1996, p. 80 in Seaman, 2008, p.3).

The complementarity of CHAT and constructivist grounded theory is also linked to the tools used to gather the data. Activity theory is a powerful and clarifying descriptive tool whereas grounded theory adheres to a theoretical approach (Seaman, 2008). Its methodological guidelines are well defined but not overly restrictive, he continues. Working with them were helpful in this research when analyzing the findings without being forced to use prescribed concepts.

Constructivist grounded theory offers useful procedures for interacting carefully with data, but does not prescribe specific strategies for analyzing how social situations are constituted by culture (ibid. p.5), an important dimension in this research. This also allowed the researcher in this study to explore and interpret the data in multiple ways, before reaching a final understanding of the phenomenon.

Constructivist grounded theory can therefore be flexibly integrated with existing theories moving the approach to make it useful within different theoretical frameworks Seaman (2008) further argues. CHAT (Engeström, 1987)


and expansive learning further underscore the need for such an in-depth knowledge to enable actors across professional borders to develop innovative local solutions to solve challenges at stake.

The outcomes of constructivist grounded theory are based upon the relationship between concepts, properties as attributes or aspects of a category, hypotheses and lastly theories. Theories or hypothesis are described as a set of well-developed categories that are systematically related through statements of relationship that explains some social or other relevant phenomenon (Bryman, 2008, p. 544). Whereas the constructivist grounded theoretical model enabled the researcher in this study to try understanding the perspectives, experiences and practices of the respondents and elaborate on sense making and negotiations using the concepts of CHAT (Engeström, 1987, 2001, 2008).

The multiple views, beliefs and traditional practices in indigenous and local contexts where people were facing the negative impacts of the HIV/AIDS epidemic were contested by scientific and western knowledge that challenged their cultural practices. The main challenge facing the researcher with the large amount of data was to bring out central themes or issues that reflected the contextual realities, experiences and views addressed by the informants. In the following section, this process will be further explained.

Validation and triangulation

The researcher used different methods for checking the credibility of the main findings, categories, themes and accounts. Field notes, minutes and outcomes of the various activities were discussed with the two core team members responsible for implementing the HIV/AIDS project in the province. One being a senior educational advisor and the other a highly experienced head teacher, they both had extensive experience and knowledge working with HIV/AIDS in different contexts, and jointly we looked over and discussed the analysis and supporting data, before submitting a formal report to the Province Education Management Committee (PEMEC).

In addition, the researcher compared the findings by checking these understandings with the original informants, e.g. by following up through regular monitoring visits over the course of the project, and other stakeholders similar to them, using multiple qualitative analysis, e.g. surveys, and open ended interviews, comparing two or more varied qualitative perspectives and also sources.

Where appropriate, ‘triangulation’ with relevant external sources, first and foremost, reviewing minutes from similar workshops and seminars, e.g. introduction to the HIV/AIDS project involving new districts, monitoring activities as well as capacity building exercises conducted without the researcher being present, and other research projects, reports, newspaper articles and policy documents including quantitative data (Elliot et al, 1999, p.222). Those processes also ensured the core coordination team to reach to a common understanding of


what we had witnessed, and to agree on the way forward. Through the ongoing sharing, reflections upon actions and views from the respondents, the outcomes of the close interactions validated the findings and, enabled the researcher to eliminate any misunderstandings and confusion.

Limitations

The construction of meaning and understanding of reality is influenced by the researcher’s worldviews and the perception of those studied. Therefore, the social construction of reality of the latter might vary depending on prevailing conditions at the time of the study. Moreover, opinions, beliefs and views cannot naturally be generalized because humans occupy different contexts and their worldviews vary, thus making it difficult for a researcher to replicate primary findings.

According to Lincoln and Guba (1985, p. 124) “there are always differences in context from situation to situation, and even the single situation differs over time [...] constant flux militates against conclusions that are always and forever. They can only be said to be true under such and such conditions and circumstances.” The explanation points to how challenging it is for qualitative research, most especially case study designs, to generalize their findings and conclusions derived from a particular situation. An original researcher can only create grounds for further exploration if need arises for transferability.

Realizing the difficulty in safeguarding the reported findings from being politicized by secondary analysis, the original primary researcher can only do his or her best by upholding ethical values that guide social research. As Bryman (2008, p. 507) observed, different people “adopt different stances concerning the ethical issues that arise in connection with relationships between researchers and research participants”.

Ethical considerations

Bryman argues (2008, p.121) that “In ethnographic research, the researcher is likely to come into contact with a wide spectrum of people, and ensuring that absolutely everyone has the opportunity for informed consent is not practical, because it would be extremely disruptive in everyday contexts.”

In this study, the researcher got an approval to use the data for research purposes, from the person responsible for this project in the Ministry of Education. This was also the case regarding the core partners in the coordination group, who also turned out to be some of my key informants through our close collaboration in the coordination group. Their commitment, knowledge about the cultural and educational context, made them relevant people to meet and include and their sites contributed to the outcome of the project itself. According to Bryman (2008), the overt/covert position of a researcher may in some circumstances be a matter of degree. Using a covert role also reduces reactivity,


and therefore they are less likely to adjust their behavior because of the presence of the researchers (Bryman, 2008, p.406).

Ethical concerns related to the issue of confidentiality, in particular related to places, institutions and individuals in qualitative research may not be that easy, Bryman (2008) argues, since it is difficult to “present field notes and interview transcripts in a way that will prevent people and places to be identified” (ibid. p.119). In this study, pseudonyms have replaced the real names, and the voices and views referred to is by stakeholder and not by the individual respondent. This further ensures confidentiality. Allthough, as Bryman (2008) underscores: “it may not eliminate entirely, the possibility of identification”. Having used a constant comparative method, involving all the 11 districts in one province, utilizing data from a great number of schools, an average of 8-10 in each district it should reduce the risk of identification to a minimum.

By deconstructing the processes and identifying key contradictions leading to innovation and change, any individual action or quote being used as an example were replaced by a fictitious name. This was done in order to keep the data, the analyses and any other information anonymous and thereby not recognizable to any of the districts, schools or persons related to the cohorts mentioned above.

4.7 Summary This chapter has discussed the HIV/AIDS education intervention, the background and personal context of the research, and provided an overview of the dual role of the researcher, the overlap between project and research activities. It further explored the qualitative and constructivist grounded research approach, how multiple methods were used that were complementary, and the active involvement of the respondents through their participatory role in the various project activities. Participatory learning activities, it is argued, corresponds to Smiths’ concept of decolonizing methodology, as well as to the cultural and activity based expansive learning approach captured in the third generation of CHAT. CHAT, being used as a tool for the analyses, and has been addressed as a theory complementing the grounded constructivist paradigm, where CHAT emphasizes culture and historicity, constructivist grounded theory focuses on actions of the individual groups. As Seaman also argues the ongoing evolution of grounded theory and the criteria developed in the study were continuously expanded rather than limited. The chapter also explained the sampling methods and how the data were processed. Coding and categorization were illustrated by the use of NVIVO, its tools and outcomes. Lastly, some reflections about validity and ethical considerations were identified. This leads towards the last part of the thesis, part four, which discusses the findings, the outcomes of the processes and project interventions.

Chapter 5

Drivers of HIV/AIDS in Zambia

Without knowing and understanding the modes of transmission of HIV, it will be difficult to fight the epidemic with relevant and culturally appropriate strategies, including education and information strategies. This chapter will explore HIV/AIDS transmission and the drivers of HIV/AIDS in Zambia by drawing upon relevant literature from the region, focusing specifically on the Zambia context. This review includes reports from international agencies, inputs from the National Aids Commission in Zambia, from MOE and other relevant academic sources. Lastly, this chapter elaborates on the structural as well as cultural drivers of the epidemic, important to develop preventive means.

5.1 HIV/AIDS transmission The Zambian Country Report (UNGASS, 2010) stated that understanding the factors fueling the spread of HIV is critical in order to respond with adequate interventions. In this regard, the national response to the UN was dealing with issues of poverty, gender, sexual violence, economic, socio-cultural, legal and physiological factors that are different for men and women (ibid.).

The two main modes of HIV transmission in Zambia are heterosexual transmission, accounting for 78 percent of new HIV infections, and mother-to-child transmission. Urban data in Zambia suggest that 60 percent of the new incidents were infected within marriage or cohabitation (UNAIDS 2010). Among those infected through heterosexual transmission in Zambia, UNGASS (2010, p. 28) found that there was a significantly higher HIV prevalence in:

� urban residents and couples compared to rural residents and couples; and couples with large age gaps compared to couples of similar ages.

� adult young and urban women compared to adult young and urban men;

� women travelling and spending the night away from home, compared to women staying at home.


Heterosexual transmission is exacerbated by high-risk sexual practices, socioeconomic and poverty inequalities between men and women, high prevalence of untreated Sexually Transmitted Infections (STIs) and Tuberculosis (UNGASS, 2010, p. 29). Among those infected by heterosexual transmission, HIV prevalence are highest among partners having casual sex, about 37 percent. The majority of this group accounted for as much as 31 percent for females, further confirming the socio-cultural disparity, where women have limited power to negotiate safe sex (ibid.).

In addition, the national response also recognized factors as inadequate access to information on prevention, low levels of negotiation skills, and inadequate protection under statutory and customary laws and traditions. The Zambian country report from the previous year, (NAC/MOH, 20081) also discussed the following contributing factors: drugs, poverty, illiteracy, cultural practices, e.g. polygamy and sexual cleansing, stigma and discrimination.

Cultural rituals and traditions that were among the drivers of HIV/AIDS were described in detail in MOE’s policies and strategies. By openly addressing these issues, MIE were actually going byond the taboos, the cultural borders, which illustrated the importance of including the education sector in fighting the epidemic. These factors will be further discussed.

5.2 Structural barriers and drivers of HIV/AIDS As expressed by UNGASS (2010, p. 28, ZDHS, 2007) HIV prevalence is not gender neutral. This statement was echoed by MOH/NAC (2008):

Gender issues that perpetuate the dominance of male interests and lack of self-assertiveness on the part of women in sexual relations put both men and women at risk. Women are taught to never refuse their husbands sex regardless of the number of extra-marital partners he may have or his non-willingness to use condoms. This is often the case even when he is suspected of having HIV or other STIs (p. 7).

In Zambia, the unequal power relations between men and women were fueling the spread of HIV. Zambian culture is traditionally tolerant of male infidelity even when it was clear that they might be at risk of acquiring the HIV infection.

Multiple concurrent sexual relationships, e.g. men having more than one sexual partner at time, were of the main drivers in the spread of HIV/AIDS in Zambia (Chilumba 2006 in UNDP 2007, p.44). In addition to concurrent partners within the same age group, men also engaged in intergenerational relationships, older men having sex with young girls, which again added another risk factor to the dissemination chain. Some were “sugar daddies”, men who paid

1 http://data.unaids.org/pub/Report/2008/zambia_2008_country_progress_report

_en.pdf.

Drivers of HIV/AIDS in Zambia 113

girls regularly for sex and for the social status attached to men having younger sex partners. The phenomenon is1 seen as entrapment of (often-vulnerable) young girls by offering gifts, treats, food, clothes, or money in exchange for sex. These practices were widespread in Zambia and put girls at serious risk of HIV infection.

Socialization of women

Women’s subordinate social status in Zambia brought about through socialization and deeply entrenched cultural beliefs creates the unequal power balance that were fueling the spread of HIV (MOE 2004a, p. 38). Generally, women lack control over their lives and are taught from early childhood to be obedient and submissive to males, particularly to males with commanding power such as a fathers, uncles, elder brothers or guardians.

In sexual relations, the woman is expected to please her male partner, even at the expense of her own pleasure or well-being. Dominance of male interests and lack of self-assertiveness on the part of women puts them at risk. In addition, women do not have the same educational and employment opportunities as men. These disparities in gender power relations have supported men’s simultaneous roles as husbands, stable partners outside of marriage (plot B)2, sugar daddies, and clients of prostitutes (MOE, 2004a, p.1).

Forced sex and gender violence

An alarming and apparently increasing number of abuses against girls come from members of their own families or the broader community. Given the high HIV prevalence in the Zambian population, sexual abuse carries a high risk of HIV transmission and effective protection mechanisms targeted at abuse against girls in the family are nonexistent. Even though those knowledgeable about the sexual abuse of girls, and the girls themselves, repeatedly describe abuses by uncles, stepfathers, fathers, cousins, and brothers such abuses by relatives are often hidden by the family, and the girls are silenced; some do not even attempt to disclose what is being done to them.

In 2003, a survey by ZSBS (in MOH/NAC, 2008) included questions for female respondents about forced sex. Even though it is likely to be underreported, obtaining information on forced sex is important because it serves as an indication of the prevalence of sexual violence in Zambia and of females’ ability to refuse unwanted sex. The questions on forced sex were

1 And still is as the drivers are the same today as they were about 20 years ago. 2 Plot B refers to owning a second plot of land where one can have an additional house,

business or farm. It has become a euphemism for having a partner outside of marriage.


administered only to female respondents. Overall in 2005, 15 percent of females reported having experienced forced sex, a decrease from the 16.3 percent of females who reported forced sex in 2003. In 2005, 17.7 percent of urban females and 13.7 percent of rural females reported forced sex. Forced sex was most commonly reported among the 20-24 year age group (18.5 percent). The perpetrators most commonly reported are husbands or live-in partners (67.5 percent). Other reported perpetrators are boyfriends (25.0 percent), male relatives (5.8 percent), former husbands/boyfriends (2.5 percent) and strangers (1.7 percent). From this data, it appears that the majority of victims of forced sex knew their perpetrators.

The belief that having sex with a virgin will cure HIV/AIDS may cover for a range of social practices rooted in high levels of gender violence. Though this 'myth' may not be as widespread as is commonly reported, it may be reproduced in different contexts to justify government inaction, high levels of male sexual violence, serial child prostitution, and local healers' negotiations for influence (Findings, 2005, p. 4).

Sexual abuse at school

The Forum for African Women Educationalists, Zambia National Chapter (FAWEZA) (in Human Rights Watch, 2003) has focused considerable attention on the issue of girls’ safety and security on their way to and from school. The length of the girls’ commute to school is an important factor, since their risk of sexual abuse by minibus drivers or conductors, if they take transportation, or abuse by others along the road, if they walk, can be significant. In some cases, the long distance to school, two hours walk or more in some cases creates insecurity for the girls, as unsafe structures nearer to school expose them to abuses by men (ibid. p.143).

Even school environments are not always safe, with sexual abuse or exploitation all too frequent. Teachers themselves may exchange answers to the tests or higher grades for sex, confirmed by informants from teacher training colleges during field visits (2002-2005). Most abuses by teachers are not reported, and few teachers are penalized. The laws are strict, but the most usual outcome is that a teacher would be cautioned or transferred. In other similar instances, the parents negotiate for the teacher to marry their daughter or pay a monetary compensation for the sexual misconduct by the teacher.

Suffering in silence

The fear of reporting abuse and the imperative to keep quiet about what happens to girls is widespread. According to Forum for African Women Educationalists, Zambia (FAWEZA, in Human Rights Watch, 2003), the culture of silence is the biggest problem in this country. Despite the obvious dimensions of the problem,


the reporting of sexual abuse against girls within families is relatively rare. Human Rights Watch argue that: “Girls suffer abuse in silence; it’s taboo to say a teacher or a man did this to me” (ibid. p.32). Bringing shame and stigma upon themselves and even their families by reporting sexual violence and revealing a positive HIV infection have converged to create a culture of silence. Shame associated with rape and incest also discourages the families from revealing what is happening. Far too often, the girl herself is blamed for the abuse.

According to a young girl, the society blames you and the legal system is not there to protect you, she continues; “If a girl is defiled by a relative, they want to hush it up. Culture teaches us to keep quiet about all these things” (Human Rights Watch, 2003, p. 26). The abusers, being close relatives and/or the economic providers also use their power to get everyone not to speak up. Most often the abusers were hidden by their family emmbers whereas the girls are silenced. Most of them do not even attempt to disclose what has happened to them (ibid.).

Underage sex

The HIV epidemic is pushing men to seek increasingly younger girls on the assumption that, younger girls are less likely to be HIV infected. Danger factors include men’s targeting younger girls for sex who are assumed to be HIV-negative, or based on the myth that sex with a virgin will cure AIDS. This forces girls to become sexually active at very young ages with obvious HIV risks. In Zambia, it is a criminal offense to “carnally know” any girl under the age of sixteen. Although the Penal Code stipulates such a crime with sentences up to life in prison, that provision is rarely enforced. In cases of rape or sexual abuse by acquaintances, as with abuse within the family, it is a widespread practice for the girl’s family to seek monetary compensation from the perpetrator rather than criminal penalties.

Human Rights Watch received testimonies about cases of sexual abuse of girls in many environments outside the home (and even in the home) by strangers or by acquaintances, by boys as well as men (Human Rights Watch, 2003, p. 32). Among the findings are that girls are at risk of abuse and HIV transmission in various settings including abuse by male customers when selling vegetables or other goods in markets or by the roadsides, playing on the streets in their communities and at school. Girls even face possible abuse and risk of HIV infection, according to the report, also in church.

Sex for survival

Already prevailing inequalities mean that the quality of female human capital is much lower than that of men. Women are less educated, and are locked out of opportunities to develop skills that would improve their livelihood. Women also


have less access to productive assets such as land and livestock. When the man in the home dies, the widow and her dependents are often rendered destitute. This is because her asset base is already weak. This is reinforced by property grabbing by the late husband’s relatives, also forcing widows into sex work in order to survive (Human Rights Watch, 2003).

Women, compared to men, bear a greater burden of the epidemic even when they are not infected because they are the prime caregivers of the chronically ill and orphans in the home. Orphaned girls are particularly vulnerable to abuse. In particular, orphans being cared for by relatives are acutely aware of their dependency, and fear loss of support and rejection if they reveal that they are being abused and thus do not report familial or other sexual abuse. This apparent increase in cases of abuse by family members has been linked, in part, to the massive problem of orphans and vulnerable children, which is stretching the traditional extended family structures to the breaking point. The problem of caring for these children permeates all sectors of society. Throughout the country, families are either taking in children who have lost one or both parents, often due to HIV/AIDS, or are supporting them in other ways, such as paying school fees. Vulnerable families are made more vulnerable by new orphans being brought into their extended family. This make them even more vulnerable. Where families lack adequate shelter, some children may be sent away, or they have to share a room with adults, and some may be molested. The burden on girls is always greater compared to their male siblings as argued by Human Rights Watch (2003). NAC (in Human Rights Watch, 2003) summarized the situation as follows:

In order to cope, households pull their children, particularly girls, from school, reduce their food intake and in some cases [they] resort to begging. In these circumstances, some women and girls are forced to engage in sex for money to meet their household expenses (p.37).

The girls may flee their homes due to abuse, neglect, or poverty. Those who are orphaned may often take care of younger siblings and make money to support them. In most cases, they have no access to money to start their own business or whatever. They need to make money to support their siblings. Many have to trade sex to survive and some go to the streets, where older men, most who are infected, offer them more money if they don’t use a condom (Human Rights Watch, 2003, p.37).

Although the line is sometimes blurred, there are distinctions between young women who sell sex at various times and those who are sex workers. Girls and young women may trade sex as a currency in exchange for food, money or protection but may not consider themselves as sex workers. According to the 1999 report by the Ministry of Health/Central Board of Health, this is a frequent occurrence (Human Rights Watch, 2003, p. 37). In an article in one of Zambia’s major newspapers, The Post (2004) provides some insight into the depth of the social problem:


Today, the nation bemoans the loss of morality amongst our people simply because one wants to survive. At the pace at which moral degradation is taking place, one wonders where we are going even in our fight against HIV/AIDS… There is no way we are going to fight adequately the spread of HIV/AIDS if, as a result of poverty and unemployment, young women and men are taken to the streets to sell their bodies (23.09, C. Katotobwe).

Prostitution generally refers to a woman or man who engages in sexual activity for payment. However, in the Zambian context, men are usually not associated with prostitution due to cultural values that permit and encourage male promiscuity. Traditionally, men cannot even commit adultery except with another man’s wife. Safe sex is rarely practiced within marriage. The case for women is very different in that any woman who has a sexual relationship with a man who is not her husband, whether for economic gain or not is considered a prostitute. Zambian society does not condone prostitution and a known prostitute is stigmatized (Human Rights Watch, 2003, p. 38).

5.3 Traditional and cultural drivers of HIV/AIDS It is not possible to talk about one culture in Zambia since there are 73 different ethnic groups within the country but one topic seems to have a common understanding within the different cultures; it is taboo to have an open discussion about sex. Traditionally, it is taboo to discuss sexual matters with somebody from the opposite sex unless with the spouse, and even then, these matters are hardly talked about. It is also traditionally a severe taboo to discuss sexual issues with one’s own child (Rasing, 2003).

There are no criminal or civil sanctions for HIV transmission. It is not covered by the Public Health Act, which seeks to contain and regulate infectious diseases. Traditional practices contributing directly to high levels of HIV transmission are not prohibited. Beyond women’s subordination, there are a number of traditional practices that take on added risks in the era of HIV/AIDS (Human Rights Watch, 2003). This is confirmed by MOE (2004a) when guiding the HIV/AIDS Peer Educators in their training manual to be aware of the cultural practices that often result in circumstances, which increase the likelihood of transmitting HIV. They specifically highlight initiation ceremonies, polygamy, ritual cleansing, traditional medicine, dry sex, land inheritance and customary laws. In the following section, some of these culturally embedded practices are explored.

The fight against AIDS in Africa is often presented as a fight against cultural barriers that are seen as promoting the spread of the HIV virus. This attitude is based on a long history of Western prejudices about sexuality in Africa, according to Gausset (2001), which focus on its exotic aspects only (polygamy, adultery, wife-exchange, circumcision, dry sex, levirate, sexual pollution, sexual cleansing,


various beliefs and taboos, etc.). He argues that those cultural aspects are a wrong target of AIDS prevention programs because they are not incompatible with a safer behavior, and because their eradication would not ensure the protection of people. He further argues that to fight against them might alienate the people whose cooperation is necessary if one wants to prevent the spread of AIDS. Gausset (2001) explains it the following way:

The major problems of AIDS prevention in Africa are not specifically African, but are similar to the problems existing in Europe or America. Therefore, anti-AIDS projects should not fight against one local African culture in order to impose another (Western), but should rather try to make behavior and practices safer in a way that is culturally acceptable to people (p.149).

Initiation ceremonies

Traditionally, sex education is given only within initiation ceremonies that involve grandparents, aunts and uncles, and extended family. MOE (2004, c) acknowledges the role of the initiation ceremonies as serving as a key process for young women and girls to understand sex and sexuality, but at the same time how they may contribute to the spread of HIV/AIDS.

Generally, the initiation ceremonies focus on teaching girls to be a submissive woman and being able to please her husband. This not only leads to women’s disempowerment and engendering their subordinate role, it also includes instilling the norm of not negotiating issues related to sex. In the initiation rituals, which are meant to prepare girls for marriage and teach them about sex and childbearing, a girl may be taught to focus on the man’s sexual pleasure and not to refuse her husband’s demands for sex (Human Rights Watch, 2003). In some circumstances, girls are expected to have sex soon after initiation in order to “test” their readiness for a marriage, as a learning experience. This is a practice which poses a major threat to the girls of contracting HIV/AIDS (ibid., p.38).

The information about sexual issues is usually not given to the girls through straight forward teaching, but through indirect forms of instruction such as storytelling, the use of examples, and euphemisms and metaphors (Rasing, 2003). Mentioning the word sex (in English or in local languages) is considered to be culturally taboo in Zambia. Words to describe sexual activities fall in the same taboo category. “Sleeping” and “playing” are words that are often used to describe sexual activities (Malambo, 2000).

In one of Zambia’s national newspapers, The Zambia Post (8/11, 2005), Dr. Phiri wrote in his weekly column criticizing the traditional initiation ceremonies. In it, he blamed the elderly women who run the female initiation, for maintaining outdated practices in the ceremony. He argues that,


Men are usually blamed for the subordinate status of women. This may be so, but older women should also shoulder some of the blame, especially for the vicious cycle that keeps women in virtually permanent subordination. Just yesterday and the day before, there must have been scores, perhaps even hundreds of ‘chezelas’ and kitchen parties all over Zambia. Those serious women-only secret events where young brides-to-be have to go to be taught facts of life, by several wiser and older women, just prior to marriage. At how many of these was the women taught to stand up for her rights?... [Being] taught lessons and life skills that she might need to protect herself from HIV infection in her married home? How many of these young brides-to-be are taught over and over again, that sex is the man’s inalienable and non-negotiable right? That hers is to give pleasure, and never to take? To give on demand and selflessly without regard for her own feelings or needs? That even where she has evidence that there is infidelity and that her life is therefore in danger, she should still succumb. (The Post, Zambia, 8/11, 2005).

Similar views were raised in the public discourses, where the traditional and cultural practices, here related to upbringing and initiation rites, were questioned among critical journalists.

Polygamy

Polygamy, while illegal in Zambia, is not illegal under the customary court system, local courts established in each chiefdom. The customary system encourages men to have multiple female sex partners thereby increasing the risk of HIV transmission. In the context of HIV/AIDS many experience the loss of labor, children may be withdrawn from schools to work in the farms to support the family, but also conflicts related to inheritance of land and property grabbing enforce women to remarry. Farmers may also recruit additional labor by remarrying the widows, or youths from the extended family in order to get enough workers in their field (Ajieh et. al. 2009). As MOE (2002, p.38), stated, “there is a type of unrecognized polygamy, which puts people at greater risk. In those cases, a man can afford to look after more than one wife”.

Sexual cleansing

Sexual cleansing is a practice whereby a widow has sex with another man, typically the husband’s brother, following the death of her husband. This may affect adolescent girls as well as women since there is no minimum marriage age for women or girls under customary practices. This “cleansing” is meant to purge the husband’s spirit from his wife. NAC described it as “very common and prevalent,” and explained that:


To be purged of the ‘evil forces’ assumed to have caused the death of a spouse, the widow or widower is ‘cleansed’ through the act of sexual intercourse with a relative of the deceased. Closely related to the issue of ritual cleansing is the notion of wife inheritance whereby close relatives take over the widow or widower. Both practices are insisted on irrespective of the HIV status of the person appointed to perform these rituals (NAC, 2000 in Human Rights Watch, 2003, p.21).

It is not clear how many people are infected with HIV through this practice, but the widespread acceptance of the practice puts women at a disproportionate risk from men as there is little tolerance for women who refuse the ritual cleansing.

Dry sex

In Zambia, the practicing of “dry sex” is traditionally viewed as the most satisfactory mode of sexual intercourse for men. MOE (2004a, p. 39) also recognize this practice, and explains, “Women believe that men enjoy dry, tight vaginas hence [they] engage in practices of drying up themselves” (MOE, 2004a, p. 39). Traditional medicine (herbs) are used by women to prevent vaginal secretions and make it tight in order to satisfy the man. The dryness is achieved by insertion of herbs, absorbents, and chemicals that reportedly reduce vaginal fluids and increase friction during intercourse (McKee, 2004, p.293). Given the likelihood that dry sex will cause tears and lacerations in the vaginal wall, especially among adolescent girls, the practice clearly increases the risk of HIV transmission. A 1999 report by the Zambian Ministry of Health and the Central Board of Health (in Human Rights Watch, 2003, p.22), also noted that: “to enhance male pleasure, a number of women continue to practice dry sex, which can increase vulnerability to infection through exposing genital organs to bruising and laceration.”

Traditional medicine

In addition to dry sex, some men ingest herbs to enlarge the penis for greater sexual satisfaction. In some cases, the enlarged penis can cause the partner to develop tears and bruises on the vagina which opens the way for the virus during sex (Human Rights Watch, 2003). Many cultures in Zambia also accept “mpokeleshi” or a sex helper, who is usually the wife’s young relative, which also increases the risk of spreading the virus.

Traditional healers sometimes also have sex with clients as a part of a treatment especially for infertility, again a culturally approved treatment heavily influencing the spread of the disease. Older clients of traditional healers also have sex with a virgin as a remedy for STI, HIV and impotence or for purposes of getting rich. This puts the virgin at risk of contracting HIV (ibid.). As the epidemic causes an increasing number of deaths, such cultural practices threaten


the lives of people and increase the spread of the epidemic where these traditions are being practiced.

Witchcraft

In rural Zambia, there has been a recurring theme of denial or ambivalence with respect to the existence of HIV/AIDS. For many respondents in various studies (Malambi, 2005; Bond, 1998 and Mogensen, 1995, in UNICEF, 2001), HIV-related signs and symptoms were attributed to traditional diseases and witchcraft. Having said this, HIV/AIDS and witchcraft are seen as relatively distinct. AIDS is considered self-inflicted whereas witchcraft cannot be prevented or controlled.

Witchcraft and traditional beliefs provide an effective coping mechanism for individuals and communities. To be bewitched is not shameful, it is ‘curable’ and can be managed within the local cosmology and healing systems. The burden of blame and guilt is thereby shifted to those responsible for bewitching. People who are ‘bewitched’ receive greater acceptance, better treatment, and can be open about their condition. They receive sympathy and understanding (UNICEF, 2001).

According to Colson (2002 in UNICEF, 2001) relatives may also suspect AIDS but they keep up a front of going to n’gangas (traditional healers). Colson reveals how being ‘bewitched’ is socially more acceptable than exposing one as HIV positive. His respondent argued that it is easier to be bewitched than expose your HIV/AIDS status, coming from misbehavior, and in turn being exposed to negativity and stigmatization.

Local courts and customary laws

While some urban Zambians are married in civil rites governed by the Marriage Act, which sets out nondiscriminatory rules for property division and inheritance, most rural (and urban) Zambians are still married under customary law. Local courts thus determine many of their core legal rights. In addition, according to the Local Courts Act, section 12(2): “Any offence under African customary law, where such law is not repugnant to natural justice or morality, may be dealt with by a local court as an offence under such law notwithstanding that a similar offence may be constituted by the Penal Code or by any other written law.” The local courts do not, however, have jurisdiction to try more serious offenses, including murder and rape, which must be heard in the magistrates’ court or High Court.

In practice, the non-discriminatory protections contained in the Marriage Act are rarely implemented. Battery, rape, defilement, and murder of women in domestic incidents are criminal matters covered by the Zambia Penal Code that are not meant to be heard in the local courts. These matters are nonetheless


sometimes taken up by local courts, and organizations frequently protest their handling in those venues (Human Rights Watch, 2003, p.56).

Problems may arise when the laws under the two legal systems conflict, even though the Local Courts Act makes it clear that in such instances statutory law should take precedence. When customary law takes precedence, it often happens that “the worst victims are women and girls, stemming from social and cultural factors which degrade the position of women and girls” (ibid.).

The Marriage Act says that the legal age of marriage is sixteen, and that anyone under twenty-one who is not a widow or widower needs written consent from the father (or mother or guardian, if the father is dead or of unsound mind) to marry. If the father refuses consent, the child can apply to a High Court judge to provide consent. In addition, the penal code makes sex with a girl under sixteen a crime punishable by up to life in prison. However, the Marriage Act does not apply to marriages under customary law, where the age of marriage is considered to be maturity. Maturity is not defined and there is no minimum age set: in some cases, maturity can mean thirteen years old or the onset of menses (ibid). In practice, especially in the rural areas, it is commonplace for girls to be married or expected to have sexual relations under the age of sixteen, and virtually unheard of for prosecutions under the penal code to result.

Despite the guarantees for nondiscrimination in the Zambian Constitution, customary law and practice place women in subordinate positions1 (U.N. Common Country Assessment for 2000, p.65). The discrimina-tion relates specifically to situations with respect to property ownership, inheritance and marriage, despite constitutional and legislative provisions. For instance, “property grabbing” by the relatives of the deceased man continues to be rampant, particularly when local courts have jurisdiction. Even the fines imposed by the Interstate Succession Act are extraordinarily low (ibid). These discriminatory practices also increase female vulnerability to HIV. One therefore finds that in Zambia, some of the factors contributing to [the spread of AIDS] are imbedded in customary laws and practices, especially in relation to divorce, adultery, child marriages and defilement (ibid.).

The Women Law in Southern Africa (WLSA) report on gender violence noted that the practice of paying lobola under customary law restricts a woman’s ability to leave an abusive marriage. Once the lobola has been paid, traditional law says that the bride essentially becomes the property of the man and his family. This has been a contributing factor to early marriages for girls. The report states that the lobola system in which marriage payments are made to the family of the bride also serves to enhance the woman’s vulnerability to violence at the hands of her future husband. In that way the commercialization of lobola has led to the commodification of girls (Human Rights Watch, 2003, p. 57).

1 See: http://www.undg.org/archive_docs/1695-Zambia_CCA_-_2000.doc


Property/land inheritance

Nowhere has the conflict between customary and statutory law been as evident as in the question of inheritance. This conflict is compounded by HIV/AIDS, since families often seek to disinherit children orphaned by AIDS and women widowed by AIDS. Inheritance has been governed by both customary and statutory law and is further complicated by diverse traditions among Zambia’s seventy-three ethnic groups. Still, tradition in most ethnic groups in Zambia and in the region dictates that the deceased man’s family retains all inheritance rights. Girls face particular risks of being disinherited following the death of either a father or a husband since girls are often married to older men, they can be widowed when they are still children (Dr. Phiri, The Post, 0506, 2006). He continues;

“Property-grabbing”, unlawful appropriation of property by relatives or others, is the main abuse associated with inheritance rights. This practice has potentially dire implications for the widow and children, who may be left destitute, with girls being propelled, in order to survive, into risky professions with the risk of contracting HIV/AIDS. Notwithstanding the enactment of the law on succession, widows may be stripped of all the matrimonial property and sometimes even of their children upon the death of their husband. The practice stems from a manipulation of customary laws, which assumes a husband’s sole ownership of matrimonial property and passes such ownership to a male relative of the deceased who is then supposed to assume responsibility for the widow and children (“widow inheritance”) (ibid.).

His article confirms the overall legal practices in Zambia, and the fact that where relevant, the customary laws overrule the actual legislative laws in Zambia.

5.4 Stigma, power and discrimination For nearly two decades, as countries all over the world have struggled to respond to the HIV/AIDS epidemic, issues of stigma, discrimination and denial have been poorly understood, often marginalized within national and international programs. In some ways, this is paradoxical, since concern about the deleterious effects of HIV and AIDS-related stigma has been voiced since the mid-1980s (Aggleton, 2003). Stigma, according to McKee (2004), represents one of the primary obstacles to achieving change in social norms and individual behavior. It has devastating effects on the morale of those living with HIV and AIDS, and People Living with HIV/AIDS (PLWHA) have reported that the stigma of HIV/AIDS is far worse than the disease itself. He further argues that stigma may be the area in which communication strategies have the greatest comparative advantage to make a difference (McKee, 2004, p. 288). The challenge though is


to identify the many and varied ways that stigma impedes prevention, testing, care, support and treatment of HIV/AIDS in a given context.

Parker and Aggleton (2003), suggest that stigma can become firmly entrenched in a community by producing and reproducing relations of power and control. In order to legitimize and perpetuate inequalities, they further argue is used by dominant groups sometimes based upon gender, age, sexual orientation, class, race or ethnicity. By doing so, the dominant groups effectively limit the ability of stigmatized groups and individuals to resist because of their entrenched marginal status (ibid.). Furthermore, according to Goffman (1963) the stigmatized often accept the norms and values that label them as having negative differences (ibid.). The stigmatized individuals/groups somehow accept that they “deserve” to be treated poorly and unequally, which make it even more difficult to create resistance towards stigma and discrimination (Nyblade, et. al, 2003, p.8). In that way, the stigmatized reduce their opportunities through discriminatory actions. Discrimination is not to be conceptualize as separate from stigma, but as the result of the process of stigma. Discrimination is thus defined as the negative acts that result from stigma and that serve to devalue and reduce the life chances of the stigmatized.

Stigmatization therefore describes the process of devaluation within a particular culture or setting, where certain attributes are seized upon and defined as discreditable or not worthy. In the case of HIV/AIDS, stigma may be applied to actual infection or to behaviors believed to lead to infection. Because HIV/AIDS first affected groups of people who were already socially marginalized, the stigma attached to HIV/AIDS is often layered upon pre-existing stigmas of sexual conduct and drug use (Herek & Glunt 1988; and Maluwa et al., 2001, in Parker and Aggleton, 2003). Stigma therefore plays into, and reinforces, existing social inequalities, being linked to power and domination in the community as a whole. The link between stigmatization and discrimination is explained by Maluwa et al (2001), stating that:

Discrimination is essentially the different, and most commonly negative, treatment of an individual or group of individuals because of one or more factors attributed to them. Stigma and discrimination are intimately linked; stigmatization often leads to discrimination, and discrimination can take many forms (Maluwa et al, 2001, in UNICEF, 2001, p. 4).

Throughout much of the global South, bonds and allegiances to family, village, neighborhood and community, collectivistic opposed to individualistic societies, according to Hofstede (1993) make it obvious that stigma and discrimination. When and where they appear, are social and cultural phenomena linked to the actions of whole groups of people, and are not simply the consequences of individual behaviors (UNAIDS, 2000, in Aggleton 2003, p.16).

It is important to recognize that stigma arises and stigmatization takes shape in specific contexts of culture and power. Stigma always has a history that


shapes how and when it appears. Understanding this history and its likely consequences for affected individuals and communities can help us develop better measures for combating it and/or reducing its effects. Beyond this though, it is important to better understand how stigma is used by individuals, communities and the state to produce and reproduce social inequality (ibid., p.17). As early as 2001, UNICEF (2001) acknowledged that HIV/AIDS-related stigma has been a major stumbling block in addressing all aspects of HIV prevention, treatment and care across the globe. An analysis of the nature of such stigma, its forms and determinants in different societies and contexts, can assist policymakers and non-governmental organizations in ensuring that initiatives aimed at reducing stigma are integral to HIV and AIDS program planning UNICEF (2001). Findings from research conducted in four contrasting countries in different geographical regions, including Zambia, revealed numerous instances of stigma. While there were many similarities in its causes and manifestations, there were also clear contextual differences. Stigma was reported everywhere to be more extensively directed against women than against men. Women throughout the research were subjected to stigma as women, as HIV-positive women and as HIV-positive women who are pregnant and/or have children. The impacts of the stigma surrounding mother-to-child transmission prevents women coming forward for testing, reduces their choices in terms of health care and family life once they are known to be HIV positive, and negatively impacts on their quality of life (ibid., p.1),

Secondary stigma manifests itself in many of the same forms as primary stigma, but in particular through social exclusion and gossip about the behavior and HIV status of those associated with PLWHA. While it is faced or experienced by all people who are associated with people with HIV or AIDS, family members, children, caregivers and even friends, those most affected are children and other family members. Whole families, in particular, are stigmatized if certain family members have HIV or AIDS (Nyblade, 2003, p.34).

In Zambia, stigma has resulted in people being denied food or care, evicted from their homes and violently attacked. Fear of stigmatization prevents people from going for Voluntary Counselling and Testing (VCT). Stigma also prevents People Living with HIV/AIDS (PLWHA) from disclosing their status, protecting their sexual partners and asking friends or family for support. The fear of being associated with those who are HIV positive prevents people from disclosing their status, as well as going for testing. Stigma limits the effectiveness of prevention efforts. Because of stigma, people may deny that they are at risk, avoid getting tested, fail to use protection, and they may avoid discussions of HIV/AIDS altogether. HIV/AIDS-related stigma, and its associated discrimination, is known to negatively affect all aspects of HIV prevention, diagnosis, treatment and care (Brown, 1999). Reducing such stigma is therefore a vital in both


stemming the epidemic and providing adequate care and support to those affected.

Stigma continues to force people to deny the presence of HIV/AIDS in their families or communities. A growing number of orphans and vulnerable children, and the struggle felt by individuals and families to cope with the illness on their own, make it crucial to highlighting the need for honesty and openness. If the epidemic is to be addressed and mitigated, openness is a requirement, and more knowledge on these issues is urgently needed according to McKee (2004, p.102) and Wallace (2004, p.13).

5.5 Concluding remarks

This chapter has described a number of key structural and cultural drivers of HIV/AIDS in Zambia. The key structural factor relates to the subordination of women. The chapter highlights structures that reduce the ability females have to negotiate sex, and the related issues of the limited power to deny sex to husbands, relatives and others. In addition, the poor socio-economic status of women and girls, particularly orphans, pushes them into prostitution that further increases their risk factors. Since “sex” as a word is viewed as a taboo, and having sex outside marriage brings about the fear of stigmatization, females who are sexually abused often remain silent, leaving crimes unprosecuted. The chapter also highlighted Zambian cultural practices and traditions related to gender, power, sexual practices and stigma that exacerbate vulnerabilities within the Zambian population in general. This underscores the need to work with Chiefs as their role in HIV/AIDS mitigation at the local level is critical. In the next Chapter the role of the traditional leaders will therefore be described.

Chapter 6

Role of Traditional Leaders

This chapter provides an overview of the historical and recent traditional African leadership power structure and the role chiefs play in the African, and in particular in Zambian everyday life. It will also show how the traditional leaders, (usually called the chiefs), have proven to play an important role in development, and in particular, fighting HIV/AIDS. A more detailed description of the traditional leadership structure in Zambia and the chiefs’ formal and informal role in development during the pre-colonial and post-colonial periods will also be explored. Lastly, the chapter will highlight some of the traditions and cultural practices, commonly defined as customary laws and practices, with relevance for the understanding of the HIV/AIDS context and challenges in preventing the disease. The selection of the customary laws and practices presented here are based on the key cultural practices enhancing the spread of the epidemic according to the literature review, MOE, and other keyinformants.

6.1 Traditional rulers, chiefs and kingdoms in Africa According to Cambell (in Gyekye, 1997, p. 117), “The structure of an African state implies that kings and chiefs’ rules by consent. A rulers’ subjects are as fully aware of the duties he owes to them as they are of the duties they owe to him, and are able to exert pressure to make him discharge these duties”. Traditional African cultures, for example, usually were strongly constitutional, with major customary limits on rulers and numerous maxims clearly expressing the reciprocal bond between the ruler and his people. Authentic traditional cultural practices and values can be an important check on abuse of arbitrary power. The constitutionality of the political practice stems not only from formal political structures and relationships but also from an awareness by the chief that his authority derives from his people. That fact establishes a reciprocal and, perhaps, also a contractual bond between the ruler and his people. Gyekye (1997, p.118) explains; “...it could be said that in traditional African politics the people, the common people, not the chiefs or kings, are the basis of all properly constituted


authority”). Sillitoe (1998) further argues that those who have lived in Africa know that the African people are democratic to a point of inaction. Things are never settled until everyone has had something to say. The traditional African council allows the free expression of all shades of opinions. Any man has full right to express his mind on public question (ibid.). Gyekye (1997) citing Julius Nyerere, provides further testament to traditional African democracy: ”The elders sit under the big tree and talk until they agree. The praxis of talking until one agree and reach consensus is essential to the traditional African concept of democracy” (Gyekye, 1997, p.118).

According to Mbigi (1995, in Van der Colff, 2003, p. 257), the main stem that underpins the values of most of African history can be traced through Ubuntu, which can roughly be translated to togetherness. Further, ubuntu can be seen as the key to all African values and involves collective personhood and collective morality. In trying to explain African management, empowerment and transformation, Van der Colff (2003) explains the relevance and relationship between ubuntu and leadership through the metaphor of the concept of the African tree. Here ubuntu can be viewed as the tree-trunk consisting of three main root systems. One he calls leadership legitimation, another, communal enterprise, and the last one, is called value sharing, consisting of sub-branches of interconnectedness, continuous integrated development, respect and dignity, collectivism and solidarity (ibid.).

In the same way, Van der Colff (2003) refers to the term ubuntu by saying that traditionally, African leadership is built on participation, responsibility, and spiritual authority. According to Lessem and Nussbaum (1996) African leadership requires the elements of transparency, accountability and legitimacy (ibid., p.258). The only way in which leaders can be legitimate is to be role models for their followers through their actions. The leader as role model includes the ability to foster a productive working environment, through the leader’s personal convictions and skills. “Leaders must see their employees as resources that must be valued and developed to build their opportunities and in this way build their own legitimacy” (ibid.).

Cultural beliefs and traditions are an integral part of a society’s contextual reality, by giving meaning to and guiding the lives of the people. In the pre-colonial era, most ethnic communities in Africa were guided by worldviews and value systems in which spirituality became the guiding force for all human activities and development (Dei, et al. 2002, Wangoola, 2002 in Owour, 2006). As also stated by Mpofo (2002, in Ngara, 2007), modern Africans operate within multilayered knowledge systems, where the critical issue is to harmonize their present with the past. In order for people to go beyond basic customary law and violate a taboos they still believe they will have to suffer the consequences (Ngara, 2007).


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Chieftainship and political authority

There were four major types of indigenous traditional leadership structures, or political organizations in pre-colonial Africa, according to Reagan (2005). These were 1) stateless societies, 2) chiefdoms, 3) kingdoms and 4) empires with the sizes of African kingdoms varying enormously and dispersed geographically. There was also considerable diversity with respect to the characteristics and organization of the different kingdoms, but the chiefdoms probably constituted the majority of specific political entities (ibid.). The term chief is somewhat problematic, and has been used not only for a village leader but even for a king or simply an honoured person. In addition, the relatives and supporters of the chief also played significant social and political roles. Hatt (2004) made a typology of different traditional political authorities describing characteristics related to how a chiefdom works within the society as a whole. The main characteristics of a Chiefdoms he argues were:

� autonomous multi-community political units � centralized political systems � office of a chief, whose persona may be more or less sacralized. � close relatives as administrative staff � associated with agrarian societies with differentiation in productive

specialization between communities. � status differentiation of members, typically of the sort known as

“ranking” (ibid.p.5).

Vincent (1990, p. 325-29 in Hatt, 2004) noted that like any typology, cases may fall in between the various designated types. In real-world cases, countries may fall in between the categories, but may also be situated in more than one category. As Hatt (2004) further explaineed it, where e.g. a traditional polity is conquered by the state. As illustrated in chapter 3, describing how the Zambian legislation actually allowed the customary laws to overrule legal governmental acts, e.g. related to abuse of women and issues related to land and property heritage. Hatt (2004) further argued that the nation state also may give tribute to the conquering ruler, its populace continued to be governed by its traditional leaders and thus being insulated by its leaders from direct experience of the encapsulating state (ibid. p. 6).

This is an instance of what might be called indirect rule in a colonial context, where traditional authorities function somewhat like interpreters between the structures of the colonial and traditional system. As will be further explored below, chiefdoms also constitute the traditional leadership structure in Zambia, and are comprised of a multi-community or multi-village based political unit, where the chiefdom is regarded as sacred, which presupposes some degree of status differentiation of members, i.e. a ranking and hierarchical system.

The chiefdoms in the province at scrutiny in this study had a paramount chief at zonal level (a sub unit of aprovince) that coordinated and addressed


issues emong the chiefs within the zone. Each kingdom had its own autonomy where the chiefs had the aouthority through their own, internal council, also referred to as parliament.

The subject units or chiefdoms were formed by the villagers. Most typically they comprise of a multi-village structure. The chiefdom is headed by a chief and a council of elders, also called headmen (HM) which had an administrative responsibility for villages. Villages are further made up of several clans, headed by HM. Chiefs are selected on the basis of lineage as well as by popular selection, most often by some sort of council of elders as also recognized by Hatt (2004), Gyekye (1997) and Reagan (2005). In Southern province, there were both patry-and matry lineal inheritance of the chiefdoms.

Chiefs and development

Hatt (2004) argues that the majority of development projects addresses themselves to rather more complex political entities than chiefdoms such as states, or to those having created political jurisdictions. It could also be units designated as tribes by colonial governments, having developed their own political traditions within the context of the wider governmental orders in which they are encapsulated, or as in a post-colonial context, where chiefdoms address themselves to international or local NGOs.

An important thing to assess when working in contexts where chiefdoms and state institutions exist in parallel systems (ibid.) is what might be expected from the traditional authority in fostering social development that a regular member of the society -an entrepreneur, a public employee, a skilled community worker or activist could or could not accomplish. How does one understand the power chiefs hold? As Hatt (2004) puts it, there are many aspects of the chief’s power:

Is the power of coercion of the traditional leader that [which] is desirable to control – his (or her) power to command labour (e.g., to muster out villagers to plant trees or to work on roads)? Or is it his mystical powers (e.g., his power to taboo and, thus, to prevent his people from hunting local populations of endangered species to extinction)? Or is it his (or her) illocutionary powers – the ability to orate and speak to his people in ways that resonate with them (Bloch, 1974, p.67 in Hatt, 2004), and thus to motivate them, not in this case by threats or by orders they are obliged to obey, but by imbuing them with the desire to embrace the project wholeheartedly, of their own volition? Or is it, in fact, his example, the leader’s example is not merely exemplary in the ordinary way, but in a potent ritual way, in which the leader’s gesture presages the action of all the people? (p.19).


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As these questions show, there is no single paradigm for traditional chiefs and headmen, or elders, for them to play a role in social development. Their potential roles are numerous. But in order to assess what kind of, or if at all, the traditional leaders’ potential role in any local development initiative, it requires that each project or case needs to be analyzed in its own right (ibid.).

To what extent then, can we claim that chiefs have or even should have a role to play in the development of their nation state or chiefdom? Case studies in Botswana, Ghana and South Africa (Taarn, 2004) indicate that traditional leaders remain important to the design and implementation of development regardless of whether or not traditional leaders have statutory jurisdiction granted by the post-colonial state.

Traditional leaders seek to be active collaborators in development interventions. A major reason for the continuing involvement of traditional leaders in development in Ghana, Botswana and South Africa was that traditional leaders continued to have access, outside the state, to their own sources of political legitimacy (i.e. credibility) in their communities. The political legitimacy of traditional leaders is “differently-rooted” than that of the post-colonial state (Taarn, 2004, p.1).

The creation of the Botswana House of Chiefs is seen as recognition by the post-colonial state of the continuing, if re-defined, legitimacy of the traditional leaders, which is also the case in Zambia as will be further explored later in this chapter.

The “differently-rooted legitimacy” of traditional leaders is based on the concept of “divided legitimacy” in which political legitimacy is seen to be divided between the post-colonial state and the traditional authorities or traditional leaders. That legitimacy is derived from their constituencies, as they regard themselves as both citizens of the state with attendant rights as citizens and as followers or subjects of traditional leaders with expectations that traditional leaders can act as development agents.

According to Taarn (2004) especially in Ghana and South Africa where traditional leaders remain in large measure outside the immediate supervision of the state, traditional leaders may use their differently rooted legitimacy to advocate for community development not only with the state but also with organisations outside the control/boundaries of the state.

The ‘best practice’ model actually questions the orthodox conception of traditional leaders as ‘gatekeepers’. Use of the model is one pillar/foundation for designing development interventions in areas where there are traditional leaders. Traditional leaders are keen to understand and utilise state law to enable them to be development agents. Their studies indicated that traditional leaders are continuously redefining and reinventing themselves as development agents and gate-openers (Taarn, 2004, p.2).


6.2 Traditional leaders and governance in Zambia

Colonial period

During the colonial period in Zambia the British Government identified chiefs as a major tool for indirect rule and dominance of local people. When The South African Mineral Prospecting Company came to this part of the sub-region in the 1930-ies, now Zambia, the chiefs had established independent Tribal Chiefdoms (Gershom, 1997).

In 1937, a Native Authority Treasury was created (GTZ, 2004) where the Native Authorities (chiefs) did not perform any functions of modern administration apart from tax collection and administration of justice. Tax funds were used to provide the chiefs with a limited budget from which salaries were paid to chiefs, court assessors, clerks, and messengers attached to each chief, and later to provide funds for public works (GTZ, 2004). This arrangement restricted the authority of the chiefs as they were seen as agents of the Colonial Administration. During this period, the chiefs provided permission for mineral exploration to the mining companies. Consequently, traditional rulers lost their supremacy, status, and independence.

The chiefs also helped implement government policies and laws at local level as well as supporting the promotion of local participation in community-based projects and initiatives. The Chiefs and their HM were also responsible for settling local disputes, enhancing a sense of patriotism to the state and Britain, maintaining national security, recruiting civil servants and security personnel, persuading citizens to enrol their children in schools, and protecting the environment. This foreign rule was characterised by oppression of the local people together with their Chiefs.

According to Gershom (1997), some of the problems chiefs and their subjects faced under the colonial regimes in Zambia were:

� Lack of participation in government as voters or candidates for public office

� Loss of power over natural resources (e.g. mines) by local chiefs � Chiefs’ subjects forced to work as cheap labourers in the mines,

on farms and other places owned by the white settlers and colonisers (Gershom, 1997, p.7).

The British South African company also used local chiefs for the recruitment of workers. This method worked well as the chiefs were very influential and commanded a lot of respect from their subjects.

Advocacy groups such as the Welfare Associations which sprang up in 1912 (Gershom, 1997) as a response to colonial oppression, realized the need to include local chiefs to mobilise the people at the grassroots level to restore their rights. Civic activism and the help of chiefs were identified as major ways to


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influence society to achieve the desired change to a democratic form of government where all people could be treated as human beings and traditional authority restored (ibid. p.9).

During this period, political parties emerged and co-operated with the traditional rulers to further restore dignity and gain better treatment under the colonial government. The Northern Rhodesia African Congress was formed in 1948 and effectively mobilised public support to resist The Federation of Northern and Southern Rhodesia and Nyasaland, the amalgamation of present day Malawi, Zambia and Zimbabwe (ibid., p.10).

In 1962, the colonial government introduced the House of Chiefs (HOC). Chiefdoms were then regarded as reliable institutions that needed to be organised in order that they continue serving Colonial interests, including resisting the independence struggle. The function of the HOC in terms of governance remained indirect and against the interests of local people especially as regards independence from the colonial rulers. Their role remained mainly traditional (ibid. p.10).

Postcolonial period

According to Von Binsbergen (1987) there are few studies focusing on the roles of the chiefs in post-colonial Zambia, as was confirmed during this study, except for the study by Gersham (1997) and the GTZ study (2004). There are some regional studies offering useful insights into chiefly affairs in selected rural districts, but by and large they usually fail to make the link with the national level (Von Binsbergen, 1987). Hardly any attention is paid to chiefs in the many writings of political scientists on public administration devoted to Post-Independence Zambia. From the available literature one would get the impression that a totally consistent and bureaucratic modern state has completely wiped out the old traces of traditional rulers as could only be of interest to anthropologists, tourists and Zambian traditionalists (ibid.).

Anyone who has intensively and over an extended period participated in post-independence Zambian society cannot help but to be aware of the great importance still attached to chiefs. Nor is this importance limited to rural districts, as Zambia is among the few African countries which have reserved a specific and honourable place for chiefs at the national level, where the Hounorable House of Chiefs (HOC) as a complementary institution to Parliament. It is not entirely unlike the House of Lords in the Westminster tradition) is established and regulated in great detail in the Independence Constitution and its various amendment acts although, the HOC constitutes only one aspect of the interaction of chiefs and the postcolonial state, and probably no longer the most important aspect (ibid., p.145). Van Binsbergen (1987) concludes by arguing that the chiefly model constitutes an intimate part of


political relations and of the political culture of post-colonial Zambia, as revealed in the studies of the neighbouring countries (Taarn, 2004).

As products of modern state penetration in the early decades of colonial rule, the chiefs have in the most literal sense been part of the modern state ever since the latter’s implantation in Zambian soil. The chiefs still represent, and through their numerous subjects’ control, an indispensable part of the ideology that defines social order, legitimacy and power in the contemporary Zambian context - not just by reference to a distant past, but also to values, norms, procedures and cultural forms that are still very much alive.

The chiefs’ structure established during the colonial period remained after colonial times, when the United National Independence Party (UNIP) came to power in 1964 (GTZ, 2004). In the post-independence era, the UNIP Government did not assume the responsibility to administer the affairs of chiefs. But in 1965, while recognizing the ‘traditional’ role of chiefs, the government found it necessary to spell out the functions of chiefs. It enacted the Chiefs’ Act of 1965, which restricted the powers previously enjoyed by chiefs under African Customary Law. According to the Chiefs’ Act, Chapter 479 of the Laws of Zambia of 1 November 1965, the republican president has powers to recognise or not to recognise any chief for any reason (without explanation), including in the interest of peace, order and good governance. Under the same law the functions of the chiefs remained traditional in nature (Gershom, 1997, p.11).

The institution of the chieftaincy was further weakened by the introduction of the one-party system under the UNIP government with the 1972 Constitution of Zambia (Amendment) Act. In an attempt to complement the functions of chiefs, the UNIP Government enacted the Registration and Village Development Act of 1971. This Act, which is still in force today, was intended to encourage chiefs to participate in matters of development in their localities (sub-district structures). However, these provisions seem not to have been widely implemented (GTZ, 2004).

The introduction of multi-party politics in 1991 necessitated the newly elected Movement for Multi-party Democracy (MMD) to give back to the institution of chieftaincy its respectful role by restoring the traditional powers, authority and dignity of chiefs, but they did not take strong measures to strengthen the institution of the chieftaincy and completely ignored the existence of the HOCs. In the 1996 Constitution of Zambia, though, they recognized the establishment of the HOC for the Republic as an advisory body to the government on traditional, customary and any other matters referred to it by the President (Manda, 2005a, in Gersham 1997, p.129). Allthough no provisions were made for HOC in the national budget. Neither did it allow reigning chiefs to be partisan or to “join or participate in partisan politics”. It should be noted that until 1991 there existed a Provincial Council of Chiefs as a body for chiefs’ participation in decision-making.

In the absence of a national forum for chiefs under Chiluba’s UNIP government, chiefs from across the country attempted to create their own forum.


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This resulted in the formation of the Royal Foundation of Zambia (RFZ). However, the absence of government recognition rendered the RFZ more as a talk shop or club than a mouth piece for development (GTZ, 2004).

But under the leadership of President Mwanawasa in (2004-2008) the government attempted to restore the authority and status of the institution of chieftaincy. The vision of the ‘New Culture’ led the Government to detach itself from chiefs’ affairs and to restore ‘traditional’ authority and dignity to the chieftaincy in order to preserve local traditions, promote culture and involve chiefs in matters of development (GTZ, 2004). Today there are altogether 279 Chiefs in Zambia (Gersham 1994, Informant, 2004). They are advisory to the government and as stated in article 130 of the constitution, “There shall be a House of Chiefs for the Republic which shall be an advisory body to the Government on traditional, customary and any other matters referred to it by the President”.

The composition comprises three representatives from each province elected in their respective areas for a term of three years subject to re-election, the chairperson and deputy chairperson of the HOC should be elected by its members. The Mwanawasa government did not want the role of the chiefs to be clearly defined in the constitution, but in addition to performing their traditional duties, the chiefs were allowed to initiate and superintend development projects in their areas (Gershom, 1997, p.14).

Their role and function has a cultural reasoning, as explained in the Constitution in article 127 saying that “Subject to the provisions of this Constitution, the Institution of Chief shall exist in any area of Zambia in accordance with the culture, customs and traditions or wishes and aspirations of the people to who it applies.” Their status and responsibilities are further mandated in article 128, stating that “a traditional leader or cultural leader shall enjoy such privileges and benefits as may be conferred by the Government and the local government or as that leader may be entitled to under culture, custom and tradition”. In the constitution, under the sub-heading Functions of House of Chiefs, article 130, the The House of Chiefs may “consider and discuss any bill dealing with, or touching on, custom or tradition before it is introduced into the National Assembly, and that they also can initiate, discuss and decide on matters that relate to customary law and practice;” (author’s italics).

Despite the potential role of chiefs in the development process, the current Chiefs Act does not link chiefs to any direct development-oriented activity. However, the cited draft Chiefs’ Affairs Policy of January 1998, as revised in 2004 (GTZ, 2004) recognizes this anomaly. Through this draft policy, the government has committed itself to involving chiefs in initiating, planning, and implementing development programs by providing chiefs with an appropriate entry pointoray. What is not clear, from the policy is how the chiefs can play an effective role in the development process (ibid.). Their role in public matters, e.g. formalized collaboration with e.g public health or education, relevant in this study regarding HIV/AIDS education prevention is not clarified.


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points out that of the four chiefdoms taking part in the survey, only two were represented in the District Development Coordinating Committee (DDCC), an important governmental body at district level. The absence of such representa-tion may have implications for the involvement of the chiefdoms in developing processes in the formal, public decisionmaking levels (GTZ, 2004, p. 75).

The traditional leadership in the provinces is afforded considerable credibility and functions in many local communities, as revealed by Taarn (2005). In spite of the traditional leaders highly respected and legitimate power, they are, as reveaked in the GTZ study, not considered as formal members in the provincial, district and sub-district governmental bodies.

6.3 Chiefs’ role in fighting HIV/AIDS In the following, I will in brief refer to research reveiling how how traditional leaders have been involved in preventive action targeting HIV/AIDS in some Sub-Sahara African countries, and also bring in some examples from Zambia, published in the beginning and early stadges of the intervention.

Ray and Brown (Taarn, 2005, p. 98) note that in Botswana, the chiefs were engaged in HIV/AIDS strategic planning, being an advisory body to the government. In Ghana the traditional leaders also acted as advisers, intermediaries and educators in HIV/AIDS education prevention. They supported the fight against stigmatization of those living and affected by the disease in their communities and at the same time being “key identifiers of social and cultural practices that can contribute to the spreading of the disease” (ibid).

The feminization of the epidemic was also targeted by chiefs in Ghana, (Taarn, 2005, p.36) where gender awareness was used as a tool of in the work of the Manya Krobo Queenmothers Association. They actively educated women on HIV/AIDS and thereby developed community capacity to deal with the social pressures of HIV/AIDS on the orphans and other vulnerable groups. The study further revealed that the activities of the Queenmothers were built upon their cultural and historical authority, where the elderly women have a specific responsibility in relation to family and women issues.

There were also some examples illustrating individual interventions by the chiefs, e.g. acting as funding agents as revealed in research by Yamba B, Namakhwa S and Bamusi N. (2004 in Taarn, 2005) were the traditional leaders also mobilized resources from various stakeholders including governments, to enhance existing activities.

Infected chiefs also disclose their status, and acted as a rolemodel, as illustrated by the senior chief Nyoka. He informed IRIN Pluss News (2006) that as chiefs, “the time has now come that we lead by example”. One story from Malawi illustrates that, where a chief publicly declared that he had been living with the virus, many people were coming forward to disclose their HIV-positive status (ibid.). He was now spearheading the traditional leaders' campaign in


Malawi, stating; “As chiefs, we feel the time has come that we lead by example. It is no longer a question of asking people to go for VCT (voluntary counselling and testing), but we need to show them how we should do it.”

Communities were also being educated about the risks of cultural practices, such as widow inheritance and ritual (sexual) death cleansing. The custom had long been viewed as a way of providing social and financial security by ensuring that the responsibility of caring for a deceased man's wife and children remains in the family. But the prevalence of HIV in Malawi has transformed wife inheritance into a potentially fatal practice. “As overall leaders in the community, their involvement is important - it will help to reduce stigma and discrimination, as they dispel myths and misconceptions,” Chief Nyoka said. “If the chief is not involved, it becomes very easy for the community to resist and shun the project” (ibid.). In this regard, traditional leaders, as custodians of culture in many African communities, have an important role to play in addressing the negative socio-cultural practices which contribute to the further spread of HIV and AIDS in sub-Saharan Africa (Scorgie, 2002).

Importantly, the chiefs acted as door or gate openers to outside advocates, cooperated with them and lending them legitimacy or credibility to work in in their community (Taarn, 2005). Ray’s research (2004, in Tarrn, 2005), revealed that at their most involved, traditional leaders can be seen acting and cooperating with Non-Governmental Organizations (NGOs) as well as international agencies.

The traditional leaders themselves also used their level of expertise and spoke out on the issue of HIV/AIDS him or herself, to the community or in other instances using other means or networks. Ray (2004, in Taarn, 2005) argued that the traditional leader then somewhat associated him/herself closer to the struggle against the disease.

Chiefs’ interventions in Zambia

In Zambia, the Zambian Integrated Health Program (ZIHP) organized a countrywide workshop for chiefs and indunas (advisor or headman) in Lusaka in November 2003 where the roles of the chiefs in HIV/AIDS prevention were clearly outlined to discuss the problem of traditional practices and AIDS (Kazembe L. M. 2004; International Perspectives September 2004, p. 5). More than 100 chiefs and 300 indunas participated, the biggest turnout of traditional rulers in years, to discuss how to fight the disease. Zambian President Mwanawasa told the chiefs; “You are all able to induce behavioral change with respect to such matters as sexual cleansing, wife inheritance, early marriages and initiation, which in some cases contribute to the spread of HIV/AIDS.” This position of President Mwanawasa was not without controversy, as traditions vary widely throughout the country (ibid.p.5).


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Some argued that witchcraft causes AIDS, among them one female participant from a Western fishing town, “Here people are not just dying of the talked-about AIDS, but there is also AIDS caused by witches.” Two senior chiefs also argued that using condoms “would defeat the purpose of cleansing.” As an article in one newspaper covering the workshop put it, “Many chiefs…said that their villages risked being cursed if ‘true’ sexual cleansing did not take place, as the deceased would come back to haunt.”

Some of these traditional rulers, though, had a different view on that issue. One of them happened to be senior Chief Mukuni (of Livingstone). Allthough highly valuing their culture and traditions, he draws a line when it came to certain sexual practices. “We know that many of our people are dying as a result of these traditional practices,” he told the Times of Zambia last December. He continued; “We have agreed to start discouraging our people from getting involved in these practices, because if they are not careful, we shall all be wiped out and there will be no chiefdoms to rule” (ibid.). Another, senior Chief, Chairman of the HOC supported these statements in this way; “If a man uses a condom, he is protecting three lives: the man’s, the woman’s, and the unborn child’s.” These chiefs stressed that cultural practices e.g. sexual cleansing and wife inheritance contribute directly to the spread of HIV/AIDS.

The two leadership structures, or ‘dual leadership’ system in Zambia, where one have the elected members of parliament (MPs) and the other hereditary traditional chiefs make it difficult to promote and implement existing HIV/AIDS strategies. These two groups, according to Scogie (2002) maybe pulled in different directions, with the former tolerating condoms, but the latter calling for youth abstinence backed up by virginity testing (Scorgie, 2002). Even at this workshop, actually drewing a favorable response to calls for action, only a handful of chiefs also volunteered themselves to be tested for HIV/AIDS (International Perspectives, Sept 2004 p. 5). Grassroots passivity were exacerbated by the contradictory tendencies of local leaders, opposing the existing national strategies Scorgie, (2002) further argues.

As can be seen from the examples above, in 2003/4, Zambian chiefs were in general not ready to involve themselves in fighting the epidemic allthough, with some exceptions. But the meeting with the chiefs, and the campaigns conducted against HIV/AIDS in certain chiefdoms helped raise the awareness that certain traditional practices can expose people to HIV and AIDS (ibid).

6.4 Concluding remarks The chapter has described the potential of including chiefs in development, their roles and legitimate governing bodies, now existing in parallel with the elected governmental structure in Zambia. Their formal position in the Zambian society was fomalized and recognized as a government body, from the national level, the House of Chiefs, down to the individual chiefdom, each of them variying widely


in size, and diverse regards characteristics, structures and priorities. Some chiefs adhere to their traditional legitimacy, custodians of traditions, whereas others are taking on a developmental approach, including new knowledges in order to improve the conditions and the sustainability of their chiefdoms and villagers. The importance of mitigating HIV/AIDS was endorsed by many of the influential chiefs but as the preventive means might impact on traditional and cultural customs, rites and practices, it was also contested.

Some were directly involved, others had a more peripherical role to play, and some were not ready to fight HIV/AIDS, as they at the same time also had to fight some of their traditional practices. Their actions can be clustered as interventions within their chiefdom, within the structure of House of Chiefs, or as collaborating partners across different activity systems. Their agency as legitimate leaders and role models is an aspect relevant within all their various mitigating interventions. How these issues played out during the research period will be addressed in the findings chapters.

Chapter 7

HIV/AIDS Prevention prior to the Project Intervention

The following three chapters present the main findings, emphasizing the views, roles and inputs from the various stakeholders involved. The first, Chapter 7, comprices the findings from the initial school mapping surveys, conducted prior to the HIV/AIDS intervention, ISACA. The next focuses on the involvement and negotiations between the various actors and the last findings chapter responds to research question three, the impacts of the interventions.

This chapter responds to the first research question focusing on and exploring how the MOE HIV/AIDS policies and strategies were perceived and practiced by those implementing HIV/AIDS education prevention in 2002. Using Engeström’s concepts of contradictions, this section illustrates the gaps between the policies and strategies and their implementation.

After first identifying the contradictions between the challenges faced by MOE local actors, district and school employees in the implementation of HIV/AIDS education, this chapter also highlights core contradictions occurring during implementation of the two concurrent strategies for the HIV/AIDS prevention education. The second section highlights and explore how the Zambian National Aids Council’s (NAC) strategies are aligned and contradict the national policy for HIV/AIDS education (MOE, 2002), focusing on their local implementation.

7.1 School surveys

District and school level HIV/AIDS prevention education

In the early stages of the program design and implementation in 2002, a.ll respondents revealed that they were all either infected or impacted by the deciese. This underscore the devastating consequences the HIV/AIDS epidemic impacted the lives of the majority of the population. This common finding was also the result of a plethora of stakeholder meetings, e.g informal group


discussions, initial informational meetings with PEO and DEO staff, teacher training college representatives, combined with numerous school visits and collaboration with I/NGO representatives, being the source of the baseline data. The findings and empirical analyses from these inquiries identify gaps and challenges the districts, schools and their employees faced in implementing the HIV/AIDS prevention strategies, illustrating what Engström (1987) terms contradictions.

Voices from school principals and teachers: caught in culture In 2002, the District Education Board Secretary (DEBS) called a meeting with approximately 12-14 school principals to discuss the five core BESSIP strategies, one being the HIV/AIDS education strategy. In groups, principals had been advised to prepare a short presentation on the challenges of implementing the various BESSIP components. HIV/AIDS education was the last out of five themes presented in that meeting. However, no principal came forward to present that topic. The DEBS (f.n.c1) then called the meeting to take a short break, and informed the researcher that, there might be some difficulties. Everybody then went for tea and the DEBS had a talk with those responsible for the HIV/AIDS component. After the break, and some hesitation, one of the female principals finally looked down, took the prepared presentation out from her bag, excused herself and said: I don’t feel comfortable talking about this (f.n.c1). Thereafter she started reading directly from the pre-prepared document.

The scenario described above is indicative of the state of anxiety experienced by dedicated and professional educators when expected to openly discuss HIV/AIDS issues in 2002. In this formal context with the principals’ superior (DEBS) in charge of the meeting and additionally, in the presence of international consultants and members of bilateral donors one would expect that the principals responded to their assigned tasks. This is even more relevant for Zambia, a country with a high power distance index (Hofstede, 1980) where subordinates are expected to, and tend to obey the authority of their superiors (Inglehardt, 2005; Sydhaugen and Cunningham, 2007).

This experience revealed how deeply the taboos and stigmas related to HIV/AIDS were internalized in the population, even within a group of educated and professional principals responsible for implementing HIV/AIDS education in their own schools. Intuitively, the cultural traditions and norms inherited from ancestors throughout generations, the taboos thoroughly described in Chapter 3 overshadowed the objective for the meeting; sharing information on HIV/AIDS education, and discussing implication and challenges related to implementation at school level.

During the baseline data collection, a school principal noted (f.n.c1): Now people do not feel comfortable talking about it [HIV/AIDS]. ...people do not open up and talk about HIV/AIDS freely, [it is] ... a part of taboos, culturally stigmatizing and surrounded by misconceptions and witchcraft. Another school principal taking part in

HIV/AIDS Prevention prior to the Project Intervention 143

the survey had a similar view, stating that: Now we are not allowed to talk about it [HIV/AIDS]. People say: “Don’t talk about it, it is a taboo” (f.n.c1). It is clear from these individual responses and from further analysis of the baseline data that cultural norms of professional educators responsible for HIV/AIDS education were powerful inhibitors to open dialogue about HIV/AIDS. Early on in the study, the notion of Zambian educators and others being “caught in culture” began to emerge.

The national policies on HIV/AIDS education (2002), which included guidelines for teachers and schools through the Interactive Manual on HIV/AIDS Education (MOE, 2003) and handbooks for Peer Educators (MOE, 2002) acknowledged these cultural norms by providing guidance and recommendations to teachers including detailed teaching plans as discussed in Chapter 5. However, the risk of discrimination and shame, not only towards themselves but also their children and the whole household, a form of secondary discrimination according to Aggleton and Parker (2003) and Women’s Watch (2003) kept people from adhering to the guidelines provided by the MOE and from talking openly about HIV/AIDS. Culture was singled out as the main reason why people did not talk about HIV/AIDS. Cultural norms proved more powerful than educational imperatives and guidelines.

The principals hesitated and were reluctant to spell out HIV/AIDS directly as with any other issues of sexuality and sexually transmitted diseases. They were fearful of breaking a taboo that was embedded in their cultural heritage. As principals and MOE employees, they were obligated to obey their superiors, the DEBS.

After the break, in the meeting first described above, and some discreet discussions with the DEBS, the principals were able to address their task. What became clear, however, were the dual mediating artifacts guiding the principals’ behavior, whether to follow the cultural scripts or follow their professional obligations as MOE employees. The mediating cultural artifacts situated in their lived world, guiding and controlling the principals’ actions and behavior took precedence over the authority of their superior, the DEBS.

The power of culture, manifested itself by the way the culture mediated the behavior of the principals (Daniels, 2012; and Bernstein, 2010). They found themselves in the dilemma; they were caught in an inner conflict on whether to follow the cultural norms of not breaking a taboo, opposed to follow their professional duties according to the educational rationale. This illustrates “double bound contradiction”.

What immediately guided or mediated their behavior in this meeting was the impact of their indigenous beliefs, manifested through culturally inherited schemas, and scripts (Bernstein, 2001, Cole, 1998). The cultural norms overruled their principals responsibilities, guided by BESSIP’s on HIV/AIDS education. How culture and norms guide and also control people’s behavior in the Zambian context was clearly illustrated by the way the principals struggled between two concurrent elements of symbolic power. The rules of practice are guided by


the situated and spiritual Traditional Community, rooted in Indigenous Knowledge system. Both systems carrying their specific rules, division of labor and their mediating artifacts, core elements guiding those involved in what was right and wrong, good or bad, accepted and not accepted, their knowledge and behaviors. A contradiction between two concurrent activity systems as illustrated in Figure 7.3 is what Engeström calls a quaternary contradiction.

Information gaps

In the principals’ meeting with the DEBS, 2002 (f.n.c1), one principal raised the issue of what she called an information gap between the policymakers, intermediate local education authorities and the schools. She complained the lack of openness about HIV/AIDS policies and strategies, and continued; …we have no information on the delivery of materials on HIV/AIDS...have no input to that. Still we know nothing about implementation, when and how to implement the curriculum…seem to be no networking or information about this: printing, delivery, implementation etc....

The group of principals supported this view, further reinforcing the views expressed by actors at the province as well as district levels. The information gaps, exemplify what Engeström (1986) characterizes as a polyfony of contradictions, e.g. where the same activity can focus on different aspects of the objective.

The other primary contradiction emerging within the same domain, the division of labor, related to the hierarchical chain within the education sector, or the education rationale itself. The system did not seem to have the capacity to inform the implementing bodies in ways that could make principals be able to execute existing policies and strategies at the school level. There were information gaps, between the MOE, at exo-level, to reach out to the actors at school level. This is an inherent systemic dysfunction according to BESSIP’s decentralization strategy, a key implementation strategy.

In spite of the existing national strategy on HIV/AIDS education (MOE, 2001b), there existed no comprehensive strategy on how to reach out to the local schools, supporting them with teaching material, tools or artifacts required to implement the existing policy and strategies, e.g. the object of activity. This indicates that a secondary contradiction occurred here between two constituent elements within the activity system, between the rules and the tools/artifacts. As the subjects, represented by the principals, did not know about the various rules, education policies, curriculum or teacher-centered methodologies, illustrates another secondary contradiction. It shows that the same activity can address different secondary contradictions between other constituent elements in one activity system, termed multiple secondary contradiction.

In other words, the principals focused on the contradiction between policy and strategies, the rules and regulations and the lack of tools to implement the existing policy on HIV/AIDS education. This illustrates a breakdown between


the sets of actions that can realize the new object of activity, e.g. the implementation of the new HIV/AIDS policy. The challenges faced by the principals illustrated the lack of coherence between two or more elements in the activity system, the rules, division of labor, and tools. Under these conditions, a large gap existed between actual policy and its implementation; thus, the actual execution of existing policies had many shortfalls.

Role of the schools in HIV/AIDS prevention In the same meeting another principal, calling for a greater role of education in HIV/AIDS prevention. She pointed out the importance of utilizing the schools as channels for skills development: HIV/AIDS prevention should not be as now, leaveing it in the hands of the health sector (fn.c1). A male principal supported her, adding; Within the educational sector, the structure should be utilized in sensitizing pupils. We have our zonal meetings, we have discussed curriculum issues, it should not be difficult to implement HIV/AIDS education, provided training were developed to help teachers counsel their pupils in HIV/AIDS, and schools were facilitated with equipment, education for life (fn.c1).

The participants started questioning the ongoing MOE practices, and turned out to try to find solutions to the issues. They discussed and negotiated different strategies, focused on the important role the education sector potentially could play as a social vaccine. It seemed as if they, after having been able to open up, break out of their cultural rationale and place themselves into the educational rationale, they were eager to discuss the epidemic and its impact on education and the role education could play in fighting HIV/AIDS, and engaged in the first phases of expansive learning.

In the Zambian case, the educational structures, policies and strategies were in place to start implementing HIV/AIDS prevention education. In order for the schools to carry these policies forward, the principals also highlighted the need for tools, or mediating artifacts enabling them to implement the policies at school level, pointing at teaching material and the need for in-service training of teachers. The principals strongly argued that the schools should and could play a central role in HIV/AIDS prevention, but as one of them said (fn.c1): MOE should go down to the grassroots level, information should go from DEO to schools immediately. She criticized the top down approach, by blaming the line departments for not informing them about the execution of the educational policy.

This managerial practice executed by MOE mirrors the authoritarian, or top down MOE governing structure which culturally were accepted as a norm (Hofstede, 1986, Inglehardt, 2005). For example, with HIV/AIDS education, MOE centrally submitted a circular (2000) to each school principal requiring five minutes of HIV/AIDS sensitization every morning. The principals had internalized top down management procedures being consistent with the norms in a hierarchical, traditional society. The principals did not question the hierarchical structure nor did they indicate any innovative or alternative strategies


in which to engage with MOE officials. Rather, the principals’ standpoint was to blame the MOE for not delivering the needed support according to national policies and strategies on HIV/AIDS education.

In summary, the findings from initial meetings with the DEBS revealed that MOE’s HIV/AIDS strategies (MOE, 2002, 2003) were contradicting cultural norms. Most importantly, the content reflected in the syllabus, regarding HIV/AIDS and in the Interactive Methodology on HIV/AIDS (2003) required openness about HIV/AIDS, e.g. the various drivers of the epidemic, infection modes and impacts.

Secondly, MOE’s internal procedures did not apply to BESSIP’s decentralization requirements, and from the principals’ perspectives, information about existing policies, strategies and the delivery of the necessary teaching tools were basically absent.

Thirdly, BESSIP represented a change from a centralized to a decentralized approach. The delegation of authority made a shift contradicting previous strategies and practices, and required a change within MOE’s internal rules of practice. The move towards a link between the schools and the community, as addressed (MOE, 2003a) required a more holistic approach to learning, where the principals were supposed to involve the whole school and engage with the local community.

Lastly, MOE introduced different teaching methodologies, e.g. interactive teaching and child centered approaches, emphasizing dialogue between teachers and pupil. A learner-centered approach was a major change from the teacher-centered approach that characterized the existing teaching methodology. A teacher-centered approach would follow the traditional patterns of upbringing and socialization in a traditional Zambian way, following the patriarchic and age bound authoritarian traditions. As exemplified in chapter 3 where one of the objectives of a lesson was to enable the child to look into the face of an adult or to speak up, both practices went against the existing societal and cultural norms. Teachers, pupil, parents and learners in general would find these new approaches not just challenging from a methodological point of view, but from a cultural perspective as well.

HIV/AIDS prevention education at school level To further gain knowledge contributing to a broader understanding of the HIV/AIDS education realities at school level, a survey of approximately 50 schools in the catchment area of the provincial teachers college was conducted in 2002. The study confirmed the gaps previously identified by the principals. In the schools visited, the principals complained about the lack of information, lack of a strategy within MOE regarding material distribution, no systemic training of teachers, and no visible strategies on HIV/AIDS prevention. All principals who responded to the questionnaire (2004) expressed that teachers in general did not feel comfortable talking openly about HIV/AIDS, as open dialogues and


discourses related to HIV/AIDS and sexuality were not culturally appropriate. The power of culture in regulating teachers’ and in general people’s behavior was a constant refrain from principals and teachers themselves. This confirms the controlling aspect of historically accumulated cultural practices, as an overarching symbolic power affecting the actions and everyday life of people in general. The findings further confirmed the information gap, from MOE HQ through its various line offices down to school level.

Five-minute HIV/AIDS approach Schools that were participating in some HIV/AIDS prevention activities followed the five-minute approach to HIV/AIDS education, most of which could be characterized as the so-called selective teaching approach (Action Aid, 2003). In addition to repetitive slogans as for example, “HIV/AIDS is killer” and “Abstain and be faithful”1. The teaching was otherwise guided by an academic, scientific and rational approach to HIV/AIDS. It also resulted in students delaying their school attendance, as confirmed by principals and DEO employees during (c1) and (c2) monitoring and evaluation sessions. This linear learning rationality, where cognitive learning tends to be linked directly to behavioral change has proven to fail, as revealed in research conducted by among others, Baxon and Breidlid (2009). This coincides with what was stated by one principal, Changes do not happen overnight (fn.c2), and as another stated when monitoring the HIV/AIDS activities at his school during a field trip in 2005 (fn.c3), fatalism characterizes people attitudes here. In contrast to the traditional teacher-centered approach, a more student-centered approach would apply lessons to a situation, characterized by bringing in aspects related to relevance, e.g. contextual and indigenous, IKS (Sillitoe, 1998).

Education has proven to be a “social vaccine”, as elaborated on in chapter five. One may instead ask why the challenges still are at play, and go deeper in trying to understand how one might address the challenges in a way that make the learning process contextually relevant, by engaging the learners to find solutions to the challenges people face in contexts.

The gaps and contradictions identified through the inputs from the principals, illustrate what Engestöm (1987) characterizes as a tertiary contradiction. A tertiary contradiction occurs where there is a difference between the initial situation, the dominant form of the object of activity, e.g. the HIV/AIDS education in Southern Province before the intervention, and the new object motive. This new objective (objective 3) is recognized as a “more advanced” teaching practice (Engeström, 1987) as reflected in the Zambian policies and strategies (MOE, 2001b, 2002, 2003, 2004) based upon openness, interaction and a child-centered approach.

1 From posters displaid during workshop 1, (c1)


The point of departure was the contextual realities of the learners. Dialogue and interaction enabled people to construct new knowledges based upon the knowledge the learners brought with them, while being confronted with new knowledges and perspectives in a learning setting, it being the classroom, a meeting or any other space where issues of HIV/AIDS prevention lead to interaction and learning.

These approaches to HIV/AIDS prevention have proven to give positive results also from a community perspective emphasizing communicative strategies as a means to fight the epidemic. In the Zambian context, the policies are in place, a first step towards a comprehensive, national HIV/AIDS educational prevention (Global Campaign of Education, 2005). The implementation of these strategies at school level still remains a big challenge according to the principals.

They were all part of the broader community, living within different households and chiefdoms, being ruled by consensus under the authority of the Chief-/tenses and his/her parliament and their HM/W for generations1, a culture where everyone is expected to follow the same social norms and regulations, where culture mediates behavior. Traditionally, Africans govern by consensus, e.g. ubuntu (Ngora, 2007, Taarn, 2004). When the decisions have been negotiated and approved in the parliament, the villagers, also termed followers have to respect and follow the voice of their Chief/teness. Cultural norms and traditions, for example inequality based upon age, gender and seniority as also revealed by Inglehardt, (2005) and Taarn (2004) confirmed subordination to authorities in other aspects of life as well, which is further strengthened through rites and schemas mediating everyday life.

The top-down governing MOE practices also parallels the top down managerial structure in the governing practices in the traditional kingdoms. Applying the cultural and institutional practices, principals, as employees in general, were not supposed to question the existing practice, but expected to follow the cultural norms and societal traditions. Firstly, any opposition to existing practices is viewed as inappropriate behavior, secondly, a centralized and top down approach also makes it easy for the employees, the principals and teachers, to expect that MOE should take the full responsibility to ensure HIV/AIDS prevention was implemented at school level. Except for some few principles, most of them indicated that they were not supposed to take their own local initiatives. In a context where the existing policy opened up for a 10 percent locally developed curriculum and an increased autonomy delegated to school level, this illustrated the challenges this new decentralized approach were facing. The principals might not have this information, or they might not be able to apply a decentralized and school-based approach to educational development. School-based interventions or localized HIV/AIDS prevention was not a part of their reflections or considerations in that initial meeting. 1 One Chief were no 18 in the chain of ancestors, a Chiefteness were no 19.


The contradictions within the three core domains, the rules, the division of labor and the mediating tools/artifacts in the activity system, the School Community (Figure 7.2) addressed serious lack of, or breakdown of, initial implementation ability. The lack of training is one of the necessary components in the implementation chain, related to the domain identified as division of labor. The lack of training also impacted the tools or mediating teaching artifact, again reflecting a polyphony of contradictions (Engeström, 1986, Turner, 2007). Different perspectives on the same activity thereby focus on different aspects of the objective, e.g. school level HIV/AIDs policies, the absence or lack of tools to mediate HIV/AIDS education related to material or the human resources to handle it locally. This creates a challenging, if not impossible teaching situation. Principals and teachers were untrained, did not have the teaching materials required, and the actual topic and mode of delivery were culturally inappropriate and abandoned by some parents, pupils and teachers who were taught to respect the traditional cultural context.

The cultural taboos, the stigmatization and thereby their inability to speak about HIV/AIDS, requires further explanation. It is an important socio-cultural challenge, not simply an educational challenge. This highlights the importance of culture as mediating artifacts, guiding and controlling what is viewed as appropriate behavior in a given culture at a specific time (Cole, 1998, Daniels, 2012, Wertsch, 1998). The principals, teachers and community members, have internalized the schemas and scripts regulating their behavior and social interaction. The traditional practices contradict the requirement of the remodeled teaching practices where HIV/AIDS education is merged as a cross cutting topic in the subject areas and is applied through an interactive and child-centered teaching methodology.

The two sets of expectations created a dilemma between the regulating power mediated by the culture (Bernstein, 2001) guiding peoples’ behavior in contradiction to the new required strategies on HIV/AIDS prevention education reflected in the HIV/AIDS educational policy (MOE, 2002, 2003). The principals and teachers were expected to go beyond taboos and cultural scripts; they were to cross the existing borders between cultural norms and traditions, the activity system reflected their traditional community. At the same time, they were supposed to apply a learner centered and scientific way of teaching HIV/AIDS in the classrooms. The new strategy, the new objective of activity, contradicted the existing norms and behavioral patterns, moving towards a remodeled object of activity, where a new motive, or a more advanced form of that activity is required. This process constitutes a tertiary contradiction (Engeström, 1987).

Teaching material on HIV/AIDS prevention At the collaborating teacher training college, HIV/AIDS education was imple-mented as a compulsory topic in 2000/1 (lecturer, fn.c1). All student teachers


were required to conduct lessons on HIV/AIDS prevention during their teaching practice. Some of the college tutors were therefore an important resource contributing to the improvement of HIV/AIDS education within its catchment area1 and by providing some relevant teaching materials while supporting their student teachers, thereby, indirectly supporting the primary schools involved while supervising their students.

A survey was undertaken in approximately fifty urban, semi-urban and rural schools in the two pilot districts during 2002 assessing the HIV/AIDS prevention education also included a review of the teaching resources. Table 7.1 gives an overview of the existing teaching material based upon a summary of the available teaching materials in these schools, the quantity and the source of delivery.

Table 7.1 A summary of the survey

Type/category Title Quantity How obtained

Magazines Trend setters (280) 5 schools in each of the two district

CHANGES 1, (USAID)

HIV/AIDS instruction kit

Basic facts about HIV/AIDS

(3) only in 3 schools MOE

Newsletters Livingstone (20) two schools MOE

Sport coaching, football/netball

Creating motivation for teaching basic facts on HIV/AIDS

NGOs

Posters Wall Charts, (20) all urban schools few rural schools

Commercially and locally made

Story Books Different easy readers

(370) found in 10 urban schools in 5 rural schools MOE

Pictures HIV/AIDS patients Ciyuni

(5-15) in most schools, especially in rural schools

Commercially and locally produced

Brochures Assorted (3000) equally distributed College/ DEO(MOE)

Teachers Guides

(60) distributed to one school College

The survey indicates how randomly the schools received HIV/AIDS teaching material. MOE, I/NGOs were one source of delivery, others were commercially and locally distributed and lastly, some of the HIV/AIDS kits came from the college.

1 School districts.


A few brochures and posters from MOE were found in most schools. Changes I, a USAID project had provided magazines to the five schools in each district where they had their interventions1, and posters and story books were distributed unequally between urban and rural schools, the rural being the most disadvantaged. In addition, a number of teachers’ guides were provided by the college. The different contributors also had their different messages or agendas, from religious beliefs and philosophical undertones, for example Catholic Church abandoning condoms, to the approved UNAID’s approach, focusing on the A, B, C approach. This raises additional dilemmas for the schools, teachers and pupils, questioning what and how HIV/AIDS prevention should be taught in their respective contexts.

Where schools had some HIV/AIDS teaching materials, or kits from I/NGOs, there were complaints from teachers that they did not know how to use the materials and that they received little or no training. The findings from the schools were confirmed by the DEO, (fn.c1, 2002) stating that much of the teaching material on HIV/AIDS was handed to the schools by I/NGOs. Since the content reflected a HIV/AIDS context totally foreign to pupils most of these books were therefore inappropriate to be used in their local schools. He underscored that; Teachers must be trained in how to use the local knowledge, indigenous knowledge, also indigenous skills, (need to) use local stories Views from a principal (fn.c1) from a basic school echoed this and stated that; The school curriculum does not include the culture itself. Another principal (fn.c2) exemplified the implications of these gaps regarding the HIV/AIDS prevention activities indicating that; people are fatalistic, the gaps between the reality and the needs are too big to bridge.

The survey illustrates how randomly teaching material actually was distributed to the schools, how it varies in all aspects, quantity-wise and differences related to type of text, e.g. brochures, books, guides, pictures, and the source of delivery. Lastly and not least important, the content seemed alien to the contextual realities, which created a barrier to actually disseminate the information needed to prevent the spread of HIV/AIDS.

Where MOE was unable to deliver according to policies and implementation strategies, a number of external actors, local and international NGOs, both religious and civic actors were executing the same actions simultaneously. These external actors were delivering teaching material on HIV/AIDS and also intervening and engaging in activities at school and/or district levels directly. More than 30 different CBOs and I/NGOs were identified during a brainstorming workshop in Livingstone in 2003 (fn.c2) illustrating the challenging or impossible task of coordinating efforts. The diverse and often contradicting HIV/AIDS prevention message being conveyed were often at cross with the comprehensive, relevant and national HIV/AIDS strategy.

These uncoordinated initiatives were conducted as a stand-alone activity. In Engeström’s terms, called neighboring activities, being concurrent to the existing 1 Information from CHANGES, 2003


MOE efforts. As he explains, these instances usually cause conflicts or create resistance to the implementation and outcomes of the central activity, here the national HIV/AIDS strategy. This is another example of a quaternary contradiction. Based upon Engeström’s (1987) classifications, this illustrates how the identification and the classifications of contradictions emerge and result in a complex and continuing web of evolving contradiction.

Disadvantaged rural and remote schools The school survey revealed a dearth of teaching materials on HIV/AIDS distributed to school level. Rural and remote schools were disproportionately disadvantaged in this regard. During the “outreach activities” conducted by the teacher college employees, selected college tutors actually conducted Interactive HIV/AIDS prevention activities. It took place as a half day event to demonstrate interactive teaching methodology to the principal and teachers at school level, while also inviting and sensitizing the pupils and parents and other relevant community members.

The experiences gained from these events were included in the baseline study and added valuable information about the initial HIV/AIDS education context prior to the program implementation. Results from three clusters of schools (2002) revealed that three rural schools reported that they “did not have a single material on HIV/AIDS” (College report, 2002). In the urban schools all stated they had some variety of materials on HIV/AIDS including easy readers, posters, as well as teacher’s guides. The urban schools “...were far better exposed to HIV/AIDS information than their surrounding rural schools (and) in all these schools, there were viable activities on HIV/AIDS” (ibid.).

The urban schools were exposed to a number of I/NGOs engaged in HIV/AIDS prevention and care. As stated in the report, “[schools] got a lot of visits from local, national and international NGOs, and were participating in different functions and work-shops on HIV/AIDS where they got a lot of information and ideas” (College report, 2002). One of the reasons, as explained by the PEO team member during a monitoring field visit (fn.c1), was that most of the I/NGOs preferred to work in areas where they easily could reach out with their four-wheel drives.

One principal from a rural school argued (fn.c1) that they were; not knowledgeable with the kind of interventions against HIV/AIDS schools were supposed to put in place, confirming previous input from the principals meeting. A teacher (fn.c1) in another rural setting supported this view stating that; where some materials were available we do not know how to use them. This was also echoed by the teachers in the urban schools, complaining about not having received any training at all. The breakdown in the flow of information within the education sector itself was again confirmed. The rural schools, due to practical, logistical and other reasons were left behind.


It should be noted, that in 2002, there was even a rural and remotely situated DEO office in the province without telephone landlines. There was no mobile network, and the DEO borrowed walkie-talkies twice a week from the electrical plant located nearby (fn.c1, and fn.c2). During the rainy seasons the roads were flooded, and even the ferry might be forced to stay ashore. On a sunny day, though, it took about 8 hours between the PEO office and this DEO. This underscores the logistical difficulties that the MOE employees faced, and the practical conditions that would affect any policy implementation.

HIV/AIDS activities In most schools, when receiving visitors, the pupils performed by singing, or dancing and sometimes also reciting poetry. The content usually were topics related to HIV/AIDS prevention and the impacts of the epidemic. They reflected some of the content and recommendations in the syllabus of grade 1-7 as explored in chapter 5. Rhythm, dance and songs are and have its roots in IKS and African culture and traditions (Ngora, 2007). The teachers applied traditional, cultural tools and artifacts, as dances and local rhythms while including text or poems written by the pupils to address HIV/AIDS sensitization. The pupils seemed to enjoy these activities all of which they often performed during school assemblies when parents and community members were invited and present.

Although engaging and impressive to watch, the tutors (2002) argued that these HIV/AIDS performances had turned into some kind of repetitive activities, most often as a “standalone event”, without integrating the messages into a wider discourse that would bring in the contextual realities of the pupils. Furthermore, these HIV/AIDS performances and activities were not integrated as a cross cutting issue in the core subject activities, as required by the syllabus and teachers manual (MOE, 2002, 2003).

An example of how a poem seemed to be “travelling” between school or districts can illustrate this further. A poem found in one of the district-based HIV/AIDS Newsletters (district, c1, 2003) developed and distributed to the schools as a part of the HIV/AIDS program was submitted by a pupil from one rural basic school called; Cry of an orphan. It can be seen in the left column below whereas another poem referred to by CHANGES 2 (2005) can be seen in the right column.

The poems are basically identical in content, although written by different pupils at different times. The content is similar to the slogans presented on posters one could find in the schools, DEO offices or at the teacher training college, as well as part of the content in the “speeches” used in the daily school-based 5-minutes HIV/AIDS sensitazion approaches.


AIds, AIds! You are so dangerous. You have killed my mother! You have killed my father! Now I am called an orphan! I have no one to take care of me, I have no one to give me food, I have no one to take me to school, My clothes are torn, Oh, help me God.

Oh, AIDSs oh AIDS, You have killed my mother, You have killed my father, You have made me an orphan, Oh, AIDSs oh AIDS.

Source: HIV/AIDS education assessment report CHANGES 2 (2005),

Source: Livingstone, District Newsletter, (Vol. 2, 2006, p.6).

The MOE guidelines (2003) enhance activities with clear linkages to the contextual realities of the learners but frequently, the content rather reflects a generalized or stereotyped approach to the epidemic that, according to the college tutors, did not actually impact the learner’s view and attitudes towards the epidemic. This is consistent with the critique raised by Gyekye (2007, p.107 in Breidlid, 2013, p.107), when he argues that these cultural expressions, “... do not really address the underlying epistemological foundations of indigenous culture and therefore tend to become isolated from the general content of the curriculum”.

The use of local African mediating tools follow a traditional way of learning, as a way of reciting, instructing or telling opposed to the MOE (2003) teachers’ guides that emphasize a learner centered and interactive approach. The schools therefore tended to apply an approach to learning based upon cognitive transfer of knowledge, without situating it in the broader context. The mediation of HIV/AIDS education in this example, illustrates how the content is alien and detached from the contextual realities of people in general. The mediating tools, the methods and the texts, the teaching material, are not consistent with the guidelines (MOE, 2003). This is again an example of a primary contradiction, within one element in the school community system, related to the mediating tools used when teaching HIV/AIDS prevention.

From the perspective of responsibility, this is an example of Engstorm’s secondary contradiction. In this case, a contradiction between the division of labor, e.g. MOE’s responsibility, and tools and artifacts, e.g. ensuring that the schools were equipped with adequate resources, human as well as material resources, enabling them to implement HIV/AIDS education accordingly. This illustrates the polyphony of contradictions (Engeström, 1986, Turner and Turner, 2007). Different perspectives and viewpoints on the same activity can reveal different solutions to a problem, and will therefore require new negotiations until reaching consensus. In other situations, the contradictions focus on different aspects of the objective of activity, opening up for other and new solutions to the problem at hand.


Of specific interest for the HIV/AIDS prevention approach that were to be developed later was some findings revealed from the outreach activities to one of the rural clusters, specifically addressing the cultural norms and importance of context.

Chiefs’ contribution In two schools located in the kingdom of one of the traditional rulers, chief Musonda, the report from the visits noted that:

Where Chief Musonda was in the forefront in the campaign against HIV/AIDS, in this cluster of schools, the parents had keen interest in what their children were learning. They sometimes followed their children to school to see what they were doing (college report, 2002).

Chief Musonda was directly involved in fighting the epidemic. In these schools the parents also came and had keen interest in what kind of learning that took place. The chief seemed to have played a key role in attracting the parents to come to school and take part in the HIV/AIDS prevention activities.

Bernstein’s (2010) concept of symbolic power, merged together with Wertsch’s (1998) concepts of agency and the legitimate other as a secondary mediating artifact, may contribute to a broader understanding of the role of chiefs in development, specifically when contesting culture and traditions.

In the two schools where the chiefs took a lead in breaking the cultural barriers, taboos, and promoted an open dialogue about HIV/AIDS, at school level the chiefs’ role can also be characterized as the significant others according to Wertsch (1998). As significant others, here used as an artifact, a mediating tool in this context, they were influential change agents and gate opener in their kingdoms. These findings are consistent with Taarn (2004), who identified the chiefs as gate openers, in fighting HIV/AIDS in Botswana.

Chief Musonda legitimized going beyond traditional taboos, opened up, broke exisiting cultural schemas or scripts and engaged in discourses regards HIV/AIDS and prevention in his local schools.

The chiefs traditional role as leader, or Royal highness/ess in their kingdoms and their formalized position in the House of Chiefs as custodians of traditions and culture legitimate their power and underscore their importance as role models for their villagers being the most influential actors and agents for changing inherited traditions and practices in their villages.

MOE policy (2002, 2003) under scrutiny in this research, enhanced an approach to HIV/AIDS prevention breaking some of the core values and traditions in the Zambian culture. The chiefs’ traditional kingdoms historically played a conserving role in the development discourse, protecting the cultural norms and traditions that guided and regulated people’s worldviews and everyday life. Their role after independence, 1964 could also be to restrict or hinder attitudes and behaviors at odds with traditional practices, specifically when


looking into the diversity of the traditional kingdoms, their internal contextual realities and the threat of a democratic governance structure. During parlimentarism, the chiefs were sidelined from the formal governing structure, having their own parallel governing body through the House of Chiefs, and thereby excluded from participating in the local governing bodies established by the different ministries. From such a perspective, culture and traditions could actually have been an obstacle for development as argued by Gyekye (1997). Somehow, peoples’ lives were seemingly caught in their contextual realities, their situated, cultural practices in which they were encapsulated. In a context of an alarmingly high HIV/AIDS prevalence, this had a devastating impact on the lives in the villages.

When the chief in these two cases, at the contrary, attended an interactive workshop targeting HIV/AIDS prevention at schools in their own kingdom, the villagers followed him. In these cases, where the chief as a role model attended the outreach program, it also opened up for the villagers to do the same. Taarn (2004) referred to similar impacts of chiefs’ involvement in fighting HIV/AIDS in other countries in Sub-Sahara Africa. The role of the chiefs as the custodian of culture and traditions was challenged by their responsibility as leaders in a context where the devastating impacts of the HIV/AIDS epidemic threatened the livelihoods of villagers and hindered the development of their kingdom.

The two co-existing and concurrent activity systems referred to in 7.3, illustrate the dilemmas the principals were facing. The same dilemmas or contradictions could also be found in the way some chiefs actively involved themselves in HIV/AIDS prevention activities in their kingdoms. Some were activily gaining scientific, school-based knowledge through the outreach activities conducted jointly by the schools and the college lecturers, whereas others totally ignored participating in the outreach activities.

Some cultural traditions and practices acted as drivers of the epidemic, as described in chapter 2, while still being applied among the villagers as long as the spiritual beliefs mediated and controlled the life of the villagers. Some of these traditions were now being challenged and contested through the school-based HIV/AIDS prevention initiatives.

Through Chief Musonda’s involvement in a learning situation conducted by professional HIV/AIDS experts, the college tutors, he approved, through his action, that western science may add value to existing knowledge on HIV/AIDS prevention, knowledge that might support him in his fight against HIV/AIDS in his kingdom. He moved from a situation where one uncritically follows one’s ancestors, towards a situation where he as a chief is searching for new knowledge to solve new problems and challenges, by questioning and reflecting upon existing practices. By questioning and searching for answers on how to enhance the livelihood of his people in the context of HIV/AIDs in his kingdom, he implicitly applys Gyekye’s approach to (1997) cultural transformation, initiating the first stages in an expansive learning cycle.


7.2 Local context and Zambian HIV/AIDS education prevention

Local drivers of HIV/AIDS According to MOE HIV/AIDS guidelines, the potential new object of activity, as illustrated in Figure 7.3, should align with the local and contextual realities and thereby be reflected in the process of developing and implementing the HIV/AIDS education prevention strategy locally. This required not only country specific knowledge about the drivers of the epidemic, as described in chapter 5, but should be relevant to the specific contextual realities and characteristics of the drivers of the epidemic in Southern Province.

This issue was addressed during the first workshop conducted in 2002. A survey conducted by an I/NGO involved in HIV/AIDS prevention activities in one of the pilot districts had identified factors that contributed to the spread of HIV/AIDS in three districts in Southern Province. The findings are categorized in Table 7.2, based on the findings in 3 districts (CHANGS, 2002).

This overview addresses activities, practices, contexts and circumstances that may enhance the spread of HIV/AIDS. Some common features can be identified, e.g. multiple usages of unsterilized instruments and the lack of using gloves, and different types of gatherings and parties, Ngoma, Malindo, Samba Usala, are all different gatherings involving beer drinking and dancing, whereby people easily engaged in sex, protected or unprotected, including prostitution.

Church gatherings were also listed as areas for sexual transmission of HIV/AIDS, allthough contradicting with the religious messages they are conveying. Journalist Phiri in The Zambian Post (2003) commented on the same issues and criticized the church for not openly addressing the epidemic. He also questioned the fact that no priest ever had gone out to say they were infected, which obviously was not the case. He further claimed that the church only served their own interest in protecting their reputation by not opening up abput their internal issues. Polygamy, multiple partners and prostitution were all core drivers of the disease also in this province, reflecting poverty and survival strategies described previously.

As could be identified as drivers specifically reflecting Southern Province would be road constructors and truck drivers, due to the main road to three boarder countries in Kasungula disctict, tourism along Zambezi, specifically Victoria Falls and the Livingstone area, in all cases these attracted sex workers. At the same time, road constructions and tourism are not equally relevant in all parts of the districts, and in other instances there were seasonal fishing and local cultural practices giving a diverse picture of what might be the core drivers of the epidemic in a specific context.


Table 7.2 Drivers of the HIV/AIDS epidemic

Categories Rural 1 Rural 2 Urban - Polygamy - Tradition, cultural

practices - Ngoma* - Malindo* - Samba Usalale* - Early sex activities - Concert party, (tea

party)* - Multiple sexual partners - Poverty - Fishing camps - Truck drivers, - Border activities - Tourism - Lack of gloves for TBA - Tattooing using

unsterilized instruments

- Polygamy - Traditions, cultural

practices - Malindo* - Church gatherings* - Multiple sexual partners - Poverty - Traders - Road constructors, - Sex workers

- Lack of gloves for TBA - Tattooing using

unsterilized instruments

- Polygamy - Traditions, cultural

practices - Malindo* - Masaka* - Envy for luxery life - Indecent dressing - Excessive beer drinking - Church gatherings* - Multiple sex partners - Truck drivers - Frequent divorces - Rush for sex to visitors - Road constructors, - Sex workers - Rural/urban centres,

migration - Lack of gloves for TBA - Tattooing using unsterilized

instruments1

1 Malindo- is eve of any function e.g. wedding when the community gets together to drink beer

and dance for the whole night. There are a lot of pairs of lovers in such situations. Such occasions are the only ones when lovers in the villages can be together at night without being noticed. There is a lot of illicit sex during these eves.

Ngoma, concerts and discos are functions of dancing and drinking. In fact, concert party is not a tea party as such. What disco is for urban areas is what concert is for rural areas. Ngoma is ‘drum’ which is beaten for music. Ngoma is also corruptly used by young people to mean Music. So they can even refer to disco as Ngoma.

Masaka are disco houses in Livingstone and Choma. (Masaka are empty grain bags). When these disco houses started, empty grain bags were used as fences to keep away people that had not paid and also provide some privacy for people inside. This is how the two disco houses came to be called ‘masaka’. In discos, youths dance and drink and many have careless sex. Prostitutes frequent these places knowing that they will find men who would want to have sex with them. Due to drunkenness, many have unprotected sex and spread HIV.

Samba usalale is a Tonga term literally meaning ‘bath and be bright or shine’. Beautify yourself, be noticed. This comes from the notion that people normally want to be ‘ordinary’. In villages, people keep themselves clean but they do not wear their good clothes except on special occasions like Sundays or Saturdays for church services. Those who dress up flashily on ordinary days are even asked if they are going somewhere special. So, samba usalale is a deliberate way of


Examples from the various field visits also contributed to the identification of local drivers of the epidemic. In one community (fn.c2) where they were trying to get a successor after the former chief, there were big challenges related to school and parental involvement, and the school basically did not get any support from the parents, which also could be observed through the lack of maintenance and teacher and pupil attendance rates. In addition, there was a fishing camp.... termed a risky area by the teacher (fn.c2). It causes a lot of problems, he continued. Only about 20 meter away from the school, the children go there for 1-2 weeks, husbands go there, and the ladies are told when getting there to by fish: One lay and a deal, no lay no deal (fn.c2).

The seasonal fishing areas do not only put a pressure on the women coming to buy fish. In other parts of the province the fish markets also attracted sex-workers as stated in an article in Zambian Post (2006) regards this issue, the heading “Wine, women and win”, characterized the challenges faced in those areas where local conditions were increasing the risks of contracting HIV/AIDS.

In the same district, most of the farmers being cattle holders, they also practice what was termed, exchange of wives (DEO, fn.c2). The exchange could last from one week and upwards, similar practice was found among other cattle holders in another district. The husbands deliberately sold or exchanged their wives and got cattle in return as a way of commodating their wives in prostitution and sex trafficking. The wives usually also got some few cettles (ibid.) Regarding this culture, the PEO employee added (fn.c2), If a lady do not have sex with others, the husband would complain that she does not make him rich which would lead her out into promiscuity.

In another rural district where the truck-drivers usually waited for days to get their legal paperwork organized attracted sexworkers as well. The school principals in that area were worried, as many girls and families would be attracted to trafficking, getting easy money and wealth (fn.c1). In some instances, the local traditional leaders would come to people and tell them about the dangers of on-going practices. Where mothers and children go to the truckers, who then pay out in USD! What do we do? Let us lead our children not to go and get money from the truckers! (teacher, fn.c2).

These examples illustrate the importance of being aware of the local drivers in order to reach to relevant mitigating and prevention strategies. Aggleton and Parker (2003), Bohler and Aggleton (2005), MOE (2003) and UNAIDS (2004)

beautifying oneself to be noticed and of course be proposed for love. Girls who are always smartly dressed, especially in the evenings are referred to as sambe asalale, that they are going out to be noticed, proposed for sex and thus spread HIV.

Church gatherings have become places of immorality. In situations where men and women go out for church camping for a week or so, (common with SDAs) there is a lot of immorality. A few years ago, Zambia Sugar Company in one district had to ban the SDAs from using a campsite within their property because whenever they used it, the sewer lines got blocked with used condoms. (At least they used condoms)- But it is not always that these are used. So, gatherings of men and women, religious or otherwise, for an extended time (sleeping there) are problematic and in some cases, contribute to the spread of HIV (f.n, DEO, 2008).


all focus on the importance of knowing the drivers of the epidemic to successfully mitigate it. The better one know the local practices, the more concrete and specific one can be when possible ways of reducing unwanted behavior can be negotiated and designed, whom to involve, and reach to the most appropriate solution. In order to get such in-depth and localized know-ledge, it requires local expertise and knowledge, and thereby local participation.

The importance of a localized approach was also underscored by several actors, as this quote from a principal illustrates, There are negative cultural trends regarding the spread of HIV/AIDS, we need a localized approach taken local cultural issues into account (fn.c2, 2003), also supported by the district education officer, HIV/AIDS education and information demands localized activities. We are not innovative and creative enough… A challenge to take up this…. need to use local knowledge (fn.c2). It was acknowledged by MOE employees at different levels, that those mitigation strategies have to start by identifying the local drivers, and develop innovative preventing strategies taking the local realities into account.

The examples above further illustrate the fact that in addition to national and districtwise similarities and patterns for HIV/AIDS transmission also the local conditions varies. Migration and seasonal employment, e.g. fishing camps or trucks waiting to cross the country borders attracts sex workers, creates potential areas for sextrafficking and turn into what can be termed, risky areas. These differ based upon local contextual conditions or factors that contribute to the spread of HIV/AIDS.

7.3 National HIV/AIDS policies and strategies The HIV/AIDS education policies and strategies (MOE, 2001b, 2002, 2003) presented in Chapter Two where already in place at the time when the global UNAIDS strategies, as formulated in The World AIDS Campaign (2002-2003) was launced as the overall global framework for HIV/AIDS prevention. As for any other country hardly hit by the epidemic, Zambia had to align with the required framework to be eligible for funding. In Zambia, The Zamabian National AIDS Council (NAC) was established in 2002, and formulates its HIV and AIDS policy through The National HIV/AIDS/STI/TB Strategic Intervention Plan (2002-2005)1. The plan aimed at incorporating a mechanism for multi-sectorial coordination of HIV/AIDS interventions through collaboration. These mechanisms were according to the policy mainstreamed by all sectors, the public, private, and the civil society, including NGOs, religious and traditional groups. But the policy interventions, it is argued, were undertaken in an environment devoid of policy direction and guidance. The lack of national policy resulted in undue duplication of effort and waste of scarce resources

1 STI, sexually tramsmitted Infection, TB, Tubercoloses.


(MOH/NAC, 2006, 2008). How were these challenges perceived by different actors?

Findings from a mission to Zambia in 2005 (USAID, 2006e), though, revealed that in spite if its three years existence, the organizational structure of NAC suffered from clear managerial weaknesses. NAC had ensured the establishment of provincial and districts AIDS Task Forces with the overall aim to facilitate the involvement of a broad range of government agencies, civil society organizations and private businesses to fight the epidemic. However, there were still insufficient mechanisms to provide useful guidance to possible local partner organizations, a very unclear reporting systems, lack of appropriate mechanisms to review progress, and lack of systems for updating the national HIV/AIDS plans (USAID, 2006e, p. 267). Zambia was also criticized for not including civil society bodies, stating that:

However, some civil society organizations consulted suggest that, more generally, civil society’s participation in national consultation processes is tokenistic and ad hoc. Moreover, there appears to be no systematic process in place for transparent election of civil society representatives and few resources available for consultation processes. (UNAIDS, 2006, p. 22)

The first Zambian stakeholders’ workshop looking into the UNGASS reporting process was not conducted until 2007, although being initiated in 2002. It then comprised of a series of meetings where also civil society for the first time took part in, and was consulted, in the drafting of the roadmap of the UNGASS reporting process (MOH/NAC, 2008, p.64). It was concluded that civil society involvement should at a minimum include participation and the sharing of key national documents and tools relevant to the UNGASS process, participation in the larger consultations, and the implementation of the UNGASS Report recommendations as part of ongoing civil society work (ibid). But, “in spite of the new structures, it did not help NAC to target households and take into account the dynamics of the epidemic at the household level” (UNDP 2007, p.64).

The multisectorial approach, it was argued, see further details in Appendix H, had paid most attention to central sector level institutions and doing little in order to deal with micro level institutions where the households are represented and playing the most important part. This was in accordance with the Zambian established practice of a centralized governance system, where sector level institutions tended not to be accountable to people at the grassroots level (ibid. p.9). There was therefore, it was further stated, little effort in Zambia to engage stakeholders to devise workable approaches that would strengthen households’ capacity to halt the spread of HIV and AIDS and mitigate its impacts (UNDP, 2007, p. 9).

UNAIDS global strategy could be viewed as a different co-existing or con-current activity system, and thereby, in Engeström’s (1987) terms representing a


quaternary contradiction. The multisectoral nature of the UNAIDS approach should ensure a close alignment to the national HIV/AIDS education prevention strategies, crucial in order to have a comprehensive strategy reaching out to schools and communities. But the lack of alignment to existing structures and insufficient mechanisms, Zambia were facing big challenges in their implement-tation of the multisectoral NAC approach.

The general model of the educational rationale, based upon MOE structures the rules, e.g. policies and strategies, the division of labor, e.g. the various levels of the system and the mediating artifacts relied upon a consistency between these various levels to make it run smoothly. Elements in the school community comprising the exo- (here: national), meso- (here: province and districts) and lastly micro- (here school) level, used to analyze and address the inconsistency and contradictions within the MOE sector itself regards HIV/AIDS education prevention. Inconsistency about actual policies as well as roles and responsibilities may be one of the reasons for why the baseline surveys revealed quite a number of weaknesses in the implementation of the national HIV/AIDS policies.

The findings from the decentralized implementation of the MOE HIV/AIDS prevention approach in the province under scrutiny will be used to further analyze and discuss core challenges facing the lower implementation levels, reflected in the dichotomy between the global, the national and the local.

Centralized versus a decentralized approach

The centralized National Aids Council’s approach actually contradicts the concurrent approach of recent Zambian reform efforts in Educating our Future (1996) and BESSIP (2002) both enhancing a decentralized education strategy. UNAIDS centralized requirements were not at all in line with the political efforts initiated more or less simultaneously by the Zambian MOE, nor in line with the HIV/AIDS policy, which specifically is aiming at delegating the roles and responsibilities for HIV/AIDS education to employees at province, district level and school level. This illustrates how the global forces, the so-called, big plans impose certain macro-level structures upon the nation states that actually manifest themselves at local level. This will be further explored in the following, while responding to research question 2. How did this impact the education sector’s HIV/AIDS interventions in Southern Province?

The centralized NAC structures were actually in line with the cultural and historical authoritarian and centralized managerial structure in Zambia, as revealed in Hofstede’s (1980) and Inglehardt’s (2005) findings, described in Chapter Seven. NAC, as applied in Zambia (2002) may therefore even delay the new decentralization efforts in the country, and reinforce a centralized approach, as policies and strategies are not sufficient tools in order to make substantial cultural changes, unless policies actively are being used as guidelines for change,


and not just as text in a document (Bray, 2005). One of the most outstanding contradictions between NAC and MOE’s national prevention strategies was the Zambian decentralication efforts opposed to the externally introduced and centralized NAC approach.

Establishment of NAC and MOE’s involvement

Another striking observation related to the NAC approach, is the limited role, or actually lack of participation from key education sector, actors and intitutions. In spite of a set up where NAC is supposed to be designed ensuring a cross-ministerial approach to HIV/AIDS prevention and mitigation, in the Zambian context, this proved to be limited to policy rhetoric. To illustrate the lack of involvement of MOE employees in the NAC structure, one can e.g. look at their representation, or rather lack of appearance in the different NAC committees.

There was established a Cabinet Committee of Ministers on HIV and AIDS whose role had been to provide policy direction and guidance to the National AIDS Council. The committee performed a critical role of informing the government on important matters concerning HIV and AIDS in their respective line ministries all over the country. The members in the different committees are given below;

The committee is chaired by the Minister of Health, includes the Minister of Finance and National Planning; the Minister of Sport, Youth and Child Development; the Minister of Labor and Social Security; the Minister of Mines and Mineral Development; the Minister of Communications and Transport; and the Minister of Information and Broadcasting (MOH/NAC, 2008, p.10).

This clearly illustrates the lack of representatives from the Ministry of Education. When taking a closer look into the Zambia country report to UNGASS (2008), it was stated that a broad range of stakeholders were involved and contributed according to their own reporting systems. In the APPENDICES (NAC/MOEH, 2008) where the participants are listed out of the 35 people gathered, just one came from MOE. Another indication showing the absence of MOE involvement in NAC, can bee illustrated by the following, out of 7 key consultants writing the country report to UNGASS (2008), 3 came from MOH, 2 from INGOs and lastly 2 statisticians. Furthermore, the baseline data for the report was gathered from 20 stakeholders, all being government officials, but no one from MOE. The informants were staff from I/NGOs and donors, 21 representatives with different technical background and again, nobody representing the educational sector (NAC/MOEH, 2008). Lastly, in “the first broad stakeholder consensus meeting” with altogether 82 representatives, 26 came from NAC, 6 from MOH whereas the otheSrs represented the I/NGO sector and donors.


The limited involvement of MOE representatives can be illustrated by the fact that until 2008, the coordination, evaluation and monitoring of the HIV/AIDS activities were being conducted without any formal linkages to the education sector HIV/AIDS prevention activities, nor to its lower level institutions as such.

USAID (2006e) argued that NAC in Zambia was rather inactive and the National HIV/AIDS policy itself, although outlining a broad vision for a national response, it was not specific enough to provide insights and information to guide and review the progress. According to the written global NAC framework, the stragegies were developed to enhance decentralized coordination, including mechanisms that effectively would build local capacity. This would in the Zambian case enabled MOE staff at all levels to identify projects ensure information distribution and facilitate funding mechanisms (Zambia Country Report, UNGASS, 2008, p.15).

MOE’s own HIV/AIDS education strategy had in detail emphasized community involvement, the inclusion of local culture through interaction and collaboration at local level as explained in the “Interactive methodology to HIV/AIDS prevention” (MOE, 2003, see Chapter Five). Nevertheless, in its implementation strategy, MOE operates inconsistently. Their own policies and strategies are in place, but as they contradict with the Zambian centralized NAC framework, it creates contradiction located within the rules, regulations and practices, categorized as a primary contradiction.

MOE’s presence and involvement in the implementation of their national HIV/AIDS prevention strategy should then be reflected and identified by the rules, the division of labor the mediation tools (or artifacts) being a part of the ongoing practices of, their subjects, i.e. MOE employees. By not including them in the NAC structures, staff at different were unaware of existing policies and strategies for mitigating the epidemic at school and community level, probably one of the reasons causing the challenges faced by the DEO staff and school employees.

The lack of information and participation from central to local level actors were identified as a major primary contradiction within MOE’s own rules and regulation, as well as within the division of labor. The subjects, the principals and teachers expected to implement the policies, were not informed, which illustrates a contradiction between two elements in the funding mechanisms for HIV/AIDS mitigation seemed to be found as a part of NAC’s responsibility, but province, district and lower level actors did not know how to access it. This contradiction between two concurrent activities is termed a quaternary contradiction

How did these inconsistencies within MOE reflect HIV/AIDS prevention interventions at the lower levels, e.g. districts and schools according to the actors actually being responsible for the implementation?


Funding mechanisms

One core issue discussed frequently was the scarcity and lack of funding for HIV/AIDS prevention education. A MOE representative at HQ (2005, f.n.c3) admitted that their funds targeting HIV/AIDS prevention might be critical. The educational decentralization policy where the provinces applied for money based upon needs reflected in the activity plans, reflecting the inputs from the districts. Money to the education sector, it was explained went directly to the provinces, and there were barely no funding for HIV/AIDS activities through MOE HQ. These activities were supposed to be funded through the national NAC strategy.

The MOE representative (f.n.c3) further stated that It is more ideal to plan it (HIV/AIDS education activities) from province and district level. Through ZANARA (Zambian National Response to HIV/AIDS, i.e. through NAC). Provinces can apply for funds to these activities via HQ. The sector pool1 does not allocate enough money (HIV/AIDS unit, 2005). If initiatives) come from the province, the Human Resource (HR) unit at HQ will assess the application

Financial resources for any education activities, including the HIV/AIDS education programs were decentralized and a part of the overall education budget or pool. Additional funds for development and implement any HIV/AIDS prevention activities within or outside the education sector itself and where supposed to be funded through the NAC procedures.

These parallel systems with their different funding mechanisms created problems to the lower MOE levels. To follow up the policy and conduct in-service HIV/AIDS training, required funding beyond the regular budget that was needed to run the ordinary activities in the sector. One education officer explained how this negatively impacted the implementation, complaining that (fn.c3); We have not got any money for interactive methodology since 2004, in spite of the policies and on-going strategy of training the educational staff in Interactive Methodologies while also disseminate the manuals for HIV/AIDS education. At a later occasion the funding issues came up in relation to the education sector pool; Not enough money from the sector pool, the cooperation (bilateral) has given us some, thanks to that we can do some work (PEO, fn.c3). He continued, I will lobby to get funds for the running of more training work-shops in Interactive Methodology. May get additional funds from HQ. One year later, the same provincial counselor still explored ways to get funds for the activities, and told that, Some additional funds are being allocated to the HIV/AIDS education program activities from the provincial core funding, we take it from “special issues” (e.g. a specific budget item) (fn,c4).

In spite of exploring innovative ways of accessing funds for the HIV/AIDS prevention intervention, the province level lacked resources to train district and school-level implementers and run the core program activities. The implementers at province level did not know when or if money would be allocated, What

1 Multi-donor Education Sector support fund


challenges do we face? Resources! For 2005 we still may have time to negotiate the budget, reallocate some money to be used for the new districts (PEO, fn.c3, 2005). His colleague underscored the point being made, What challenges do we face? Resources! (fn.c3).

Even though Zambia actually had a national and centralized approach to HIV/AIDS education prevention, neither the central MOE HQ level, nor the NAC implementation strategy seemingly ensured that money was allocated for that purpose. A centralized activity was actually requiring a localized solution or approach to funding. The same experience emerged from the dialogues and interactions during the first planning workshop, equally relevant for all the cohorts during program intervention period when a civic leader (fn.c1) complained; We need courses in how to develop and access money from the right budgetary sources. But as also stated in UNGASS critique to Zambian MOE, the NAC set up were too complex, and the procedures to access information and funds too complicated. Other collaborating partners commented on the same issue in different ways, churches, local NGOs, and chiefs, exemplified with this comment from chief Banda (fn.c4) as late as in 2006: We have the global funds, every line ministry must apply based upon their policies on HIV/AIDS. Aren’t there committees in the districts….district HIV/AIDs task force for all line ministries? Money is there…just to go and get it!

NAC was established as a cross-ministerial body in order to provide funds for HIV/AIDS prevention, but the relevant actors at different levels within MOE did not know how to access funds through those structures. The lack of information on how to access resources for HIV/AIDS education prevention activities illustrates a breakdown between the sets of actions, which realize the activity within one element in the activity systems. These primary contradictions also clearly point to the challenges the education sector is facing in coordinating its different activities. The tools needed in order to realize the object of activity were not working, as a secondary contradiction between two elements. These dilemmas described by the different actors related to the challenging implementation procedures to realize the HIV/AIDS education prevention strategies run by MOE within the NAC’s framework as well as within the MOE’s own HIV/AIDS education prevention strategy.

Local level selection criteria and ownership

Traditional selection critrias based upon kinship (Ngara, 2005) were reflecting the hierarchical and the top-down appointment procedures within MOE. It was specifically observed and experienced when realizing how those mechanisms directly impacted the selection of staff and employees eligible for the various HIV/AIDS training programs being offered by different I/NGOs, including the project scrutinized in this study. Traditionally brotherhood, sisterhood, and the reciprocity expected within a broader communal context contradict selection based upon merits and professionalism. This is a factor that undermines merit-


based strategies. The complaint from staff at district level as expressed by a DEO employee (fn.c2) it is always the same people being selected for training. He further added, (it is) in order for people to get the allowances. Some employees were prioritized and given the opportunity to attend HIV/AIDS training programs and thereby enjoying monetary allowenses and advantages, whereas others, in similar employment positions at district level were excluded from such activities. The selection procedures applied by DEBS in some districts hindered the implementation of a strategic professional development strategy in the province. At the same time, this attitude created tension between colleagues, and even jealousy. As one officer stated (c2), if the responsibility is delegate among staff members, the one in charge is afraid of not getting the credit him or herself.

Instead of adhering to a professional and approved national HIV/AIDS strategy guiding province and district wise activities, both the selection of staff for workshops attendance, and monitoring and evaluation strategies seemed in different contexts, rather to be based upon nepotism, as indicated by the DEO (c2). One prioritized individual needs and interests rather than national, professional agreed strategies and societal goals and objectives, here capacity building required to implement the HIV/AIDS education prevention policy in the province.

Another important impact of lack of participation or involvement in the HIV/AIDS mitigation startegies was expressed by a senior province level advisor stating that, When the solution to the problem is arrived at through participation, it ensures ownership because the learner's feelings and emotions are fully involved (PEO, fn.c3, 2005). This concern coincided with DEO, (c1, 2002) explaining ownership and participation in the following way, People will participate and have a sense of ownership. The same argument was also addressed by the principal at a rural school, sense of ownership is crucial, communities need a sense of ownership, (fn.c1), further underscored by another principal (fn.c2), the strategies must be school based activities which are feasible and localized, this create a sense of ownership and sustainability.

These issues address another primary contradiction; the lack of participation, found in one element the division of labor, The DEO (fn.c1) as well as the principals (fn.c2) raised the issue of relevance, decentralization and localization. The respondents expressed that through participation one would ensure the inclusion of localized and relevant mitigation strategies.

Managerial and structural aspects The impacts of this top down NAC approach were referred to in different contexts, at different stages and at different levels during the implementation of the HIV/AIDS intervention under study. Some examples are illustrated, here, first by the voice of one of the district educational officers, criticizing the HIV/AIDS strategy from not reaching out to the schools, stating that Programs should be taken to schools when started.. planned... and monitoring programs to be put in place and followed ups being made (DEO, fn. c1).


This and similar critiques were raised throughout the program period. Even as late as at the monitoring meeting in 2006, chief Banda (fn.c4) stated, those up there (HQ) do not marry with those on the ground. His colleague (fn.c2), chief Zimba continued by adding; We have not recommended HIV/AIDs education strongly enough to the MOE, for them to listen. (It) should be part of a lesson from MOE. (they) should be serious.

MOE was being criticized for not taking HIV/AIDS prevention serious, their structures and implementation strategies do not reach down to the schools and villagers. The chiefs questioned MOE’s overall commitment to actually take the implementation of HIV/AIDS education prevention seriously. They are indirectly pointing at the primary contradiction within two of the domains in the activity system, Figure 8.2, School Community, within the rules/practices and within the division of labor, illustrated by the lack of implementation. It also reflects the inconsistency between these two components, a secondary contradiction.

During the first district-wise HIV/AIDS workshop (c1,) the district education officer explained his experiences, pointing to the lack of horizontal coordination between line ministries and among line departments and I/NGOs. Also, the vertical coordination between line ministries within MOE, were suffering. These gaps were illustrated clearly during a brain storming sessions conducted during a HIV/AIDS workshop (c3) in a semi-urban area, where the participants were representing PTA members, teachers, principals and representatives from DEOs in 2004. The session revealed that as many as 21 I/NGOs and Community Based Organizations (CBOs) were working with HIV/AIDs prevention in different schools in the district. Only a few of them were registered at DEO. Far too often, it was explained, the I/NGOs and CBOs approached the schools or clusters of schools directly.

Lack of coordination makes it difficult to maximize the utilization of human and material resources related to HIV/AIDS education and prevention and equally important, to ensure that the Zambian HIV/AIDS prevention strategies were being adhered to according to syllabi and teaching material. This exemplifies contradictions within several domains of the activity system e.g. managerial issues as division of labor, rules and regulations as well as the lack of the tools needed to implement the HIV/AIDS education at school and community level, according to policies, consistent with the approved, the object of the activity. The link between two domains illustrated here by the contradiction between rules and subjects, and the contradiction between subjects and artifacts, in the delivery and running of educational HIV/AIDS prevention, identified as secondary contradictions, within one activity system.

The annual districts work-plans and reports provided to the province level during the course of the project, as also reflected in the district documents gained from each cohort, were all using quantitative data. This was also related the case ergards training and capacity building in the areas of HIV/AIDS. At a field visit to MOE head quarter (c3), the HIV/AIDS unit, revealed that they monitored


the HIV/AIDS education prevention based upon the reports being submitted from the districts, whenever the districts had something to report. The reports were input oriented, e.g. training of x-numbers of teachers or sensitization of y-numbers of DEO employees etc. No outcome or impact measures were indicated. There were no systematic monitoring report procedures and the information was of different qualities. At the HIV/AIDS unit at HQ level, only two persons, randomly went out to the districts to get information from the field, to get additional information, through observation or small impact surveys (fn.c3). The lack of information flow between the different MOE line departments, e.g. schools, districts, province and head quarter level regards monitoring and evaluation illustrates how HIV/AIDS education and prevention actually were marginalized within MOE as such.

There were a number of primary contradictions within the domain division of labor that reduced the sector’s ability to reach its objective. This was illustrated by the centralized and uncoordinated monitoring and evaluation procedures. One of the core project team members spelled it out as follows; Delegation is a big issue in our country, people do not delegate (fn.c3). The cultural and historical explanation adds another dimension to the constraints identified, hindering an efficient implementation of the decentralized HIV/AIDS education prevention, which also can explain why HQ staff actually physically go out in the field to assess the quality of the HIV/AIDS education activities. It could be due to the lack of trust (Inglehardt, 2005) between the employees at different levels within MOE, from HQ to school and teachers’ level.

Trust is inherently built up within a collectivist societal framework in Zambia. People outside the actual kinship, or household, may be viewed with uncertainty and sceptimism and thereby not trustworthy. This is also reflected in Inglehardt's studies, where intolerance of outgroups and low interpersonal trust outside the kinship, specifically towards foreigners is listed among socalled African tyopologies (ibid). This could probably explain why HQ’s focal point HIV/AIDS employees themselves actually went out in the field to assess and experience HIV/AIDS prevention education, instead of just hand that respomnsibility over to the lover level MOE employees. Decentralized systems require delegation of power and managing such systems is to some degree also built upon trust or faith that others will accomplish their roles and responsibilities accordingly. The lack of a national comprehensive monitoring and evaluation system of the HIVAIDS interventions within MOE illustrates some of the challenges the HIV/AIDS education prevention is facing to reach its overall objectives.

In Southern Province, specifically at local school- and district level, there was a general competence gap, as well as a lack of technological and material resources required to monitor and utilize the national education data found in the education management and information system (EMIS). That can be illustrated by the fact that while conducting different capacity building activities at district and school level during the project period, the coordinators were asked


on several occasions (c1, c2) if we could help MOE employees to utilize and understand the compiled quantitative data from MOE. The fact that the EMIS indicators did not include HIV/AIDS and impact on scooling at all is another issue.

None of the MOE employees at district or school level seemed to have any knowledge about NACs global indicators used for monitoring the global HIV/AIDS epidemic, even though NAC, national office reported on the Zambian epidemic and development annually. During the 4 years of the ISACA intervention period, nobody seemed to know, to have access to them, or being involved in compiling them.

UNAIDS had developed a common global strategy, a common set of indicators to monitor and evaluate the national interventions in order for UNAIDS to measure progress of their global HIV/AIDS prevention strategy. Their quantitative indicators, though, did not comply with the local, district-wise, provincial, not even national conditions. The drivers of the epidemic that were reflecting the Zambian contextual realities did not correspond with many of the indicatots required in the annuall reports submittet to UNAIDS to measure progress.

This illustrates another quaternary contradiction, e.g. the external monitoring strategy were implemented as a concurrent monitoring and evaluation strategy, not alliged with the national strategy or approach. Such practices are also reflecting some of the main critiques of the global structures as argued by e.g. Easterly (2006) and Klees (2008), see Chapter One. But in a context where MOE in Zambia seemed to treat their HIV/AIDS monitoring fairly randomly, it would have been a challenge to see how NAC as an alternative national strategy could have supported the Zambians to improve their systems while at the same time utilizing what was needed in order to compile the gobal progress.

Country context and NAC’s indicators Indicators used to assess progress in any programs give strong direction to the program managers and implementers as to what should be addressed and followed up, in other words what tends to be prioritized areas in the annual reports. NAC is reporting to UNGASS on the annual country-based progress. Simple text search of selected documents from UNAIDS rarely showed the cultural dimensions of the epidemic discussed in brief. E.g. a search for “culture” on the Zambian Report to UNGASS (2010) only gave five hits “cleansing” came out three times, “traditional practices” and “rituals” were highlighted once. MOE (2004) on the contrary, listed a number of culture related practices as core drivers of the epidemic, e.g. traditional cultural practices as cleansing, initiation, witchcraft, stigma, gender imbalance and vulnerability, as well as poverty and prostitution. These drivers of the epidemic in Zambia were also directly addressed in the manual on HIVAIDS prevention, Interactive methodology on


HIV/AIDS (MOE, 2003). One would assume that program documents, annual reports on progress on HIV/AIDS preventions and impacts, including the indicators used to assess progress would be aligned to and reflect the drivers as expressed in the Zambian countries own programs and strategies to mitigate the HIV/AIDS epidemic. According to the multi-sectorial NAC approach, HIV/AIDS prevention education run by MOE is supposed to be included, but only one fourth of the UNAIDS funds and activities are targeted HIV/AIDS prevention (see chapter 4).

As the findings illustrate, the core indicators (Appendix X) in the UNGASS progress reports are basically focusing on condom use and sex practices among married, unmarried, female and male actors, including men having sex with men, which is an illegal practice in Zambia, and therefore not being addressed in the open. Educational interventions and the cultural dimensions are absent, and not listed among the indicators.

Certainly, these indicators reflect the overall UNAIDS focus on condoms and health prevention means in their strategy, but this also totally underestimates the value or importance of addressing the core national and local drivers of the epidemic in a regional, country and locally specific context. The top down global approach as reflected in the Zambian NAC education strategy being studied does not reach out to the local actors and grassroots main concerns, neither structurally, nor culturally, as they do not capture and address the local main drivers of the epidemic. The UNAIDS global approach undermines and do not seem to capture the local means needed to combat the epidemic, e.g. the discrepancies between the national driver of the spread of HIV/AIDS in Zambia compared with the core progress indicators focused in the global UNAIDS strategy.

Monitoring and evaluation approaches may contribute to knowledge creation where applied as a part of an expansive learning cycle, based upon critical reflection and co-construction of knowledge. Nevertheless, where the tools and indicators is not reflected or situated in the contextual realities, these exercises may at the contrary contribute to alienation.

7.4 Summary The UNAIDS multi-sectoral NAC strategy (2002) included HIV/AIDS education prevention, and applied as a cross ministerial body in Zambia. HIV/AIDS mitigation were a central component within BESSIP (MOE, 2002, 2003), the intervention being scrutinized in this research, ISACA. The findings from the surveys revealed some of the challenges the countries in the global south are facing, when signing up for global strategies, here exemplified through the Global Strategies for HIV/AIDS prevention coordinated by UNAIDS.

The baseline surveys conducted before the new intervention took place revealed that the stakeholders from MOE officials at district to school level, were


unaware of the existing policies and strategies on HIV/AIDS prevention education. They saw the importance of applying HIV/AIDS prevention as a part of the curriculum, but did not know how, they were lacking information, had not been consulted, neither received any training.

Findings revealed how the sociocultural and contextual conditions constituted the factors described as drivers of the virus. One major barrier was the taboo, it was inappropriate to open up and talk about HIV/AIDS, as it related to sex. Breaking that taboo would lead to stigmatization. They were supposed to talk about it, according to MOE directives, but were constrained by the cultural taboos, a so-called dual bound (Engeström, 1987).

The Chief’s participation seemed to attract parents and other community-members to attend the HIV/AIDS outreach activities at school. Their symbolic power as potential agents of change indicate the importance of a power dimension in CHAT, and illustrated the importance of cultural artifacts, the chiefs as the significant others as mediating tool. The diverse landscape, environmental and living condition of each local community illustrated how practices and contexts varied, also when discussing the driver of the epidemic reflected the need for a localized prevention strategy to make them relevant to the learners. The baseline surveys illustrated clearly how the meso-, exo- and local level actors perceived the MOE’s HIV/AIDS mitigation initiatives, and reflected how the macro issues impacted the actual implementation of the intended policies and strategies at the grassroots, e.g. school level.

The lack of a coordinated and holistic approach between NAC and MOE’s HIV/AIDS prevention strategies at national level, MOE’s absence in the processes and initiatives run by NAC, created a complex and uncoordinated responsibility for the HIV/AIDS implementation from national to local level institutions and actors. In addition to inconsistencies and contradictions between the two HIV/AIDS prevention strategies, the overall indicators used to assess progress in the Zambian fight against the epidemic had to follow the global UNAIDS standards. These did not reflect the diverse drivers if the epidemic in Zambia, reflecting their specific context.

In the next chapter, a localized, or bottom up approach within the same MOE framework for HIV/AIDS education prevention is explored. In the following, the stakeholders’ voices will be the basis for the development of a localized strategy, and alternative approach, supported and aligned with the governmental policies and strategies for HIV/AIDS preventive education interventions.

Chapter 8

Multi-voiced Planning and Negotiations of Interventions

This chapter explores and identifies the multiple perspectives on the main object of activity, the multi-voiced planning processes leading to the localized HIV/AIDS intervention, through the voices of the collocutors exemplifying the multi-voiced negotiations. The views, beliefs, challenges and ideas as reflected by the participants through multi-voiced planning processes are highlighted, and the voices of the different stakeholders illustrate the ways in which they all contributed to innovative reasoning and negotiations. In response to research question two the chapter further explores how interaction and sharing contributed to expansive learning where the participants jointly generated and modeled a new object of activity that responded to the needs of the stakeholders reflecting their local realities.

8.1 Common visioning The broad-based 3-day stakeholder workshop that launched the intervention created the pillars of the approach, designed the processes and the objective of activity. The outcome of that workshop provides the critical foundation that guided the HIV/AIDS intervention developed in Southern Province, ISACA. The launch of the intervention (c1), as well as the introduction to other districts, (c2, c3, c4), started with a planning workshop, that included broad participation of relevant stakeholders. Induction workshops for other districts started with a plenary session where the initial HIV/AIDS context was presented in order for all actors to get an overview of the existing baseline knowledge on HIV/AIDS as well as national and local contexts and mitigation strategies.

As the HIV/AIDS education intervention was initiated and led by MOE, their policies and strategies were a part of their introduction, followed by MOE staff at province and district level highlighting their activities and the epidemic’s impact on education. Findings from the baseline survey, as discussed in Chapter Eight were presented to the participants. Presentations were also made by


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Constructing the object of activity During the induction workshop (c1) the only female chief present, acknowledged as “The Royal Highness” appreciated the invitation and said, all here come from villages where it is chiefs, but we all (fn.c1).

Based upon thye findings from the school surveys, the Chiefs had been invited to take part in the launch of the intervention, as well as the planning process jointly with HQ, province, district and school level employees. They were not just there to approve or justify a strategy, but were actively involved as equal partners from the very beginning, as noted by chief Mosonda (c3), appreciating the fact that the chiefs were included as equal partners from the very beginning of the intervention.

All stakeholders were jointly taking part in a collective process of developing and generating a new object of activity, a localized HIV/AIDS prevention strategy. All were sharing ideas in a common social space, and ethically and politically responsible for the outcomes (Chambers 2001, Freire, 1972). In Smith’s (2008) terms, reflecting a decolonizing process.

Everybody present agreed on the urgency for the districts to engage in and renew the HIV/AIDS prevention strategies. Statements as we are all either impacted or infected (lecturer, fn.c1) coincided with the DEO reminding everybody that AIDS knows no status and has no limit (fn.c1). A precondition for an expansive learning process to lead to a new object of activity, Engestöm (1987, 2001) argues, is that the participants are motivated and engaged in reaching a solution to the problem. The importance of this epidemic, and the negative societal and individual impacts, made these collective planning meetings into a space where all participants had a stake and motivation to find possible solutions, new possible objects of activity.

The district education officer (fn.c1) greeted the house by acknowledging that: this is the very first time in Zambia all stakeholders are gathered to jointly discuss this important issue, trying to come up with suggestions for action, as was supported by the representative from MOE headquarters. Such a broad multi-voiced group had never been brought together to discuss HIV/AIDS prevention. It illustrates the lack of horizontal structures where stakeholders can meet across professional borders, where experts meet so-called novices (Edwards, 2010). The multi-voiced planning workshop (2002) was characterized as unique, and represented a new horizontal and participatory approach to find solutions to mitigate HIV/AIDS, a new intervention, e.g. a new object of activity (Engeström 1987, 2001, 2008).

The DEO (fn.c1) also commented that all age groups were represented, both genders equally represented, as well as representatives from all social, political, civic, religious and traditional groupings, and urged all to contribute to the betterment of the communities. The principal from the teacher training college further illustrated the impact of such a gathering in his concluding remarks the last day saying: Now, (we are) not afraid to sit next to chiefs! (fn.c1).


His speech pointed at the existing vertical borders, the hierarchical division of people based upon status, age and gender roles, as also reflected in the theory of world values system (Inglehard, 2005) which illustrates one of the typical characteristics of a traditional society (ibid).

By introducing broad stakeholder participation, the action transcended boundaries by breaking traditions, creating space for old and young, chiefs and followers, male and female, educated and non-educated, to jointly address the HIV/AIDS epidemic. The approach contrasted with the traditional hiearchical procedures of interacting (Gausset, 2003, Hofstede, 1986, Ngara, 2007). The traditional norms and value systems usually functioned as a controll mechanism, prevented people to move beyond boundaries and restricted multi-voiced interaction (Cole, 1996, Engeström, 1987, Wertsch, 1998). In this multivoiced context, pupils and children spoke up in front of the elders and villagers were interacting with the chiefs, a practice totally contradictingthe cultural nporms.

The college principal (c1), chairing the sessions also endorsed the diverse group of people by stating it is very joyful to see such a big assembly that has gone beyond the boundaries of traditions and taboos to discuss this issue … by actually breaking taboos by openly discussing issues related to HIV/AIDS, its causes, impacts and possible strategies for prevention. The planning workshop created space for breaking one of the key taboos that made it difficult for people to discuss issues related to the spread of HIV/AIDS in the society (Aggleton, 2003) elaborated on in Chapter Four and in the previous findings Chapter. The participants agreed to share and talk about HIV/AIDS during the planning workshops. They were all challenged and inspired to interact, aiming at finding joint solutions by following the old traditions of “Ubuntu”, e.g. togetherness (Ngara, 2007).

Also the civic leader, the mayor (fn.c1) of one of the biggest towns in the province endorsed the idea of the workshop by saying: We have not left out any level, the credit goes to the organizers, and this is how it should be. HIV/AIDs do not select by gender or social class, everybody is targeted. To each one of us -- as it has -- the impact it has... The participants should themselves come up with the impact of HIV/AIDS, the different levels of understanding on how to fight the animal called AIDS. Chiefs, councilors, they have various ways and approaches, mapping up strategies and approaches would be a good idea.

The mayor underscored the importance of a broad collaboration and participation and also focused on the gender inequality, We should not just talk about the women the men are engaged as much! (ibid), referring to the general public discourse where women were blamed for the spread of the epidemic, as referred to by Women Watch (2003) and Phiri (The Post, 2005). His remarks indirectly confirmed the status quo of gender inequality and the subordination of women in Zambia (Inglehardt, 2005, Women Watch, 2003). The structural and societal inequality between men and women, boys and girls was reflected in the discussions throughout. The mayor’s contribution, raising and taking a stand on the gender biased HIV/AIDS discourse, stating that the “men are engaged as much”, somehow set the agenda for that debate, and few voices were heard enhancing gender discriminatory attitudes, or blaming the women and girls.


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The DEO closed the plenary session and referred to the existing educational policies strategies, and underscored that the MOE’s structures are in place, from the ministry down to the individual school, and those responsible at each level already assigned their tasks regarding HIV/AIDS prevention. She therefore expected to see new HIV/AIDS prevention strategies being developed during the workshop that were enhancing the already existing structures. All stakeholders are now involved. We need close collaboration. [I].hope that the whole program can develop in an open, transparent focused collaboration, she continued (DEO, fn.c1).

This induction workshop introduced a participatory planning process. It introduced a new approach to project development, a paricipatory process where everybody took on a joint responsibility addressing and aiming to reach to ways of mitigating HIV/AIDS.

Visioning the new object of activity

In the following sub-chapter the voices of the various groups of stakeholders will be highlighted in order to illustrate their contribution and how they positioned themselves differently throughout the workshop. The sessions varied between presentations from experts as well as novices (Edwards, 2010) and presentations from group work. The groups varied from either being organized homogenously based upon their social stratification, e.g. chiefs, teachers, public employees etc. in order to reduce and minimize the impact of the unequal power distribution, caused by culture and traditional hierarchies. It can be noted here, that certainly, some representatives might carry different roles, in different situations and contexts, e.g. a head man also being a previous principal, being a father or a mother, etc. However, the fact that they also perform their roles according to the context and the activity they are assigned to take part in, also enables them to bring in different perspectives to the issues being addressed.

The chiefs, through their active involvement, executed their power as legitimate significant others (Cole, 1996, Wertch 1998), and what Bernstein (2010) categorized as regulating power, a spiritual leader guiding and controlling the lives of the villagers in their kingdom. Spiritual and religious beliefs are a part of the mediating factors guiding and controlling peoples’ lives. In the same way, Bernstein (ibid) also categorizes science and academic knowledge as another regulating factor, impacting people’s lives and behavior. The discourses reflected in this chapter as inputs to the debates and negotiations illustrate how different types of knowledges rooted in different epistemologies, are carried forward by the diverse groups of participants. Symbolic power, being spiritual or academic is rooted in different epistemologies, the western and indigenous knowledge systems, rational and cognitive versus indigenous, situated and spiritual (Sillitoe, 1998). The lectures promoting rational scientific solutions in contrast to the Chiefs, traditionally promoting the cultural and customary traditions illustrates what Bernstein categorizes as different types of symbolic power.


Social learning through horizontal sharing between stakeholders from the two interacting activity systems, Traditional- versus School community opened up for knowledge sharing that otherwise would not have taken place. The space created to facilitate these meetings, is also termed, the third space where strategic facilitation of communication across previous boundaries actually took place e.g. that opened up for new solutions to an initial practice. In the following sub-chapters, the inputs to the expansive learning process and the construction the new object of activity will be described and analyzed thematically. The first cluster of themes are related to the overall strategy, processes and responsibilities, the second cluster focuses on the impacts on culture and traditions and thirdly, the impacts on MOE activities, province district and school- and community level.

8.2 Overall strategy, processes and responsibilities

Coordination

The Mayor (fn.c1), supported by his civic leaders brought up the coordination issue emphasizing the lack of coordination among line departments and NGOs. He suggested in line with MOE representative that a constant liaison among stakeholders i.e. Churches, Trade Unions, Market, traditional leaders, etc. should be ensured (ibid.).

There were no doubts among the workshop participants that there was a need to ensure a close school-community link, and at the same time coordinate the activities to make the most out of already existing resources. The lecturers, as well as the other stakeholders, stressed the importance of working together. As was stated by the Mayor (fn.c1): As the saying goes ‘Together we stand, divided we fall’ and with collective resource mobilization it becomes much easier. A similar sentiment was expressed by a school principal (fn.c1), We have to travel together. One civic leader concluded: United we stand divided we fall (fn.c1). The participants all emphasized the importance of networking and collaboration, and built on the numerous stakeholders and their contributions to maximize the effectiveness of the strategy.

They shared a belief in collaboration, also expressed by several groups referring to the collectivist African culture, reflected in African proverbs by stating, “Togetherness, and we will win”. This is also reflected in the African term, in the Bantu languages, “Ubuntu”, as Ngara (2007) argues, translated to English with “togetherness”. This indicates how they all draw on their cultural heritage, for a call to collective action. Zambia is, as other countries in the same region, characterized as a collective society, according to Hofstede (1996). This is in contrast to most Western societies that he terms “individualistic”. Collective action through “togetherness” was enhanced and endorsed by the stakeholders in order for the project to succeed.


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Horizontal collaboration

The baseline as well as inputs to the planning workshops (c1-c4) revealed gaps and challenges in the implementation of the MOE’s HIV/AIDS policies and strategies, most of which were related to different school community domains. The chiefs complained about a total lack of traditional leaders present at the educational district, zonal and village level meetings. This gap was also identified at the level of village development committees by GTZ (2004). It was therefore suggested that the chiefs should be involved at every level in the decision-making process in the new strategy being modeled. As Chief Musonda argued (fn.c1), Close collaboration between chiefs and MOE structure has to be strengthened. Their legitimate role as custodians of the traditions and cultural practices made them important as agents for change at village and community level, but as will be discussed later, also at district, zonal and national level (Ngara, 2007, Taarn, 2004).

One of the Chiefs (fn.c1) expressed the need for an approach where there was a close collaboration and regular meetings between the MOE and the traditional leaders with the following: [there should be] regular meetings between traditional leaders and Ministry of Education and other HIV/AIDS stakeholders [and] an inclusion of traditional leaders at district and zone level.

The parents’ supported closer and broader collaboration among the different actors. One (fn.c1) argued, Interaction with the key stakeholders from the Chiefs to the Households and vice versa, to interact with all stakeholders, NGOs, Pupils, Parents as a way of Research before finding real solution. Another parent stated, if there is no communication between head teachers, PTA, HM, chiefs, community, this can fail. This is further illustrated by chief Zimba’s (fn.c1) statement that, if head teachers, PTA and community will not work together this will fail….without the chiefs, nothing will happen at the ground. The chiefs and the parents were representing the villagers. They experienced the failure of the existing HIV/AIDS prevention efforts, and were all envisioning a new intervention objective, based upon a closer collaboration between the school and the community level and the villagers, through the chiefs and his/her structures, if one should succeed.

The chiefs’ input to a new strategy was consistent with MOE representa-tives and other participants who maintained that horizontal collaboration between the traditional leaders and MOE employees, and any other relevant partner in the different public, civic or private organizations’ institutional levels was essential for success. Until this point in time, no such horizontal structures were in place. The Zambian HIV/AIDS strategy (2003) clearly emphasized community inclusion in the approach. But the MOE strategy did not directly include the traditional leaders. In discussions with MOE officials at the national level in 2005, the expectation was that NGOs would work with Chiefs while


MOE focused on their own internal activities within their sector. Examples from neighboring Botswana, though, revealed that the involvement of the traditional leaders had been crucial in fighting HIV/AIDS (Taarn, 2004).

The chiefs, as has been illustrated, endorsed collaboration with the various relevant stakeholders as a part of the new strategy ahead. Chief Musonda (fn.c1) stated that, Chiefs’ Councils and HM/W should continue to hold workshops and seminars with the Ministry of Education, Community Development, NGOs and Civic leaders in the fight against HIV/AIDS. The chiefs further emphasized collaboration, and saw the need for using the schools as vehicles for information sharing. The Chiefteness added (dn.c1), Collaboration is important in the fight against HIV/AIDS, (we need to) ...share information on the schools. It was commonly agreed that bridging the links between the schools and the community at large was a challenge one needed to reach at.

MOE representatives were all aware that resources had to be allocated and directed where needed, and it had to be done… by coordinating all activities, according to one PEO employee (fn.c1). By strengthening the coordination one could create synergies and thereby compliment and align preventive initiatives and efforts instead of duplication and/or conveying confusing and conflicting messages. Coordination and establishing forums for exchange of ideas by all stakeholders, one PEO (fn.c1) continued, was a prerequisite, for a fruitful solution.

Capacity building

The “information gap” in knowing how to address the many facets of the disease, as many participants termed it, was an outcome of the expansive learning process that had taken place during the various planning sessions. The sharing of policies, the contextual realities, impacts, drivers and mitigation strategies regards the epidemic, followed by the discussions, analyses and negotiations were all a part of the process of learning. However, as Engeström (2015) argues, you only understand these processes when being able to trace the evolution and expansion of the object.

The concrete suggestions from teachers and lecturers were similar. One lecturer stated that, (we need) more information on causes of HIV/AIDS from technical staff (fn.c1). He also argued that there was, a lack of sensitization, networking, professional know-how on counseling skills and openness to discuss HIV/AIDS issues. This was supported by one of the DEO managers (fn.c1) adding that, advocacy skills, communication skills, facilitation skills and capacity building skills were needed to sensitize and inform the public and, he continued, help them to learn better and effective ways of dealing with the problem. Similarly, the civic leader (fn.c1) addressed the lack of information and knowledge among the civic leaders themselves. He suggested that, all civic leaders should be sensitized through workshops and seminars, through pamphlets, books, brochures and posters.


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All stakeholders urged the need for more information, technical and professional knowhow about effective ways of dealing with the epidemic, implying that the local and ongoing discourses did not help them solve their problems. Their recommendation, however took the discussion one step further. One lecturer (fn.c1) argued that, we need to merge western education on HIV/AIDS infection.....and thereby enable the chiefs to take action! The royal Highness summed up (fn.c1): villages should be empowered, the people in villages should be empowered, teachers, schools, traditional leaders could help them as well. We also need to train people in the community. Cultural awareness rising is needed. Schools, community, parents, and close collaboration between chiefs and MOE… has to be strengthened.

Chief Banda addressed similar issues when he attended a monitoring session (fn.c3): I have heard, listened, learned from this workshop. Problems are identified and we will find solutions to it in our districts. DEOs, principals have an important role to play. Budgeting, planning…all being involved. Sensitization programs are vital. Working as a team! You have brought us in from the beginning. He made a specific point of the importance of being involved from the introductory meetings, through the learning process and the identification of different challenges as well as the way forward. The chiefs were recognized as equal partners in a joint effort to combat the epidemic. As Smith (1999) argues recognition through participation and involvement is what she characterizes as decolonizing methods, Freire (1978) terms it empowering strategies.

In other words, in order to reach out with adequate and necessary information, they recommended that western knowledge, or the scientific HIV/AIDS knowledge about the drivers and prevention means should be merged with traditional knowledge. The cultural knowledge mediating the behavior in the communities and villages, were not sufficient to tackle the challenges caused by HIV/AIDS. The lecturers from a neighboring college with experience in outreach activities about HIV/AIDS in their catchment area schools and , from their student teachers’ practice, and were familiar with the general local HIV/AIDS discourse, which included witchcraft and taboos among the cultural beliefs and misconceptions, as discussed in Chapter Four. The importance of not just abolishing culture (Gausset, 2004), or replacing cultural knowledge with western, but rather applying and aligning the technical knowledge with the local culture and indigenous knowledge by working jointly with and through the Chiefs became a common practice.

Bernstein’s (2010) theory of symbolic power, as also further elaborated on by Weertsch (1998), Cole (1996) and Daniels (2012) illustrates this dichotomy between the two different symbolic although regulative forces. In this specific context and time, the symbolic power, secondary and tertiary mediating artifacts, related to spiritual knowledge, schemas and rites were contested by the regulative power of academic knowledge. It became clear to stakeholders that local cultural and western knowledge had to work together were needed to resolve or mitigate


the devastating impact of the HIV/AIDS epidemic through close collaboration and shared responsibilities.

In order to improve HIV/AIDS prevention strategies one had to ensure regular meetings between the stakeholders involved. It was also agreed that clear roles and responsibilities for the different actors involved should be identified. Some examples of strategies that emerged were ways of sharing information among schools, villages HM and Chiefs to support the growing number of orphans. The chiefs, their parliaments HM wanted closer collaboration with the schools in their kingdoms with the aim of enabling them to improve direct support to orphans, a link that had not yet been in place.

The chiefs (c1) did not only focus on the importance of reaching out to their own kingdom, their schools and the community members. In the House of Chiefs, their national body, they also identified ways of extending their role and responsibilities in fighting HIV/AIDS. Chief Musonda (fn.c1) suggested that, Sensitization should be an ongoing process from the village level to the Chiefs’ Council and House of Chiefs. The chiefs present agreed to use their power and position to sensitize other Zambian chiefs on the need to apply a similar model of HIV/AIDS prevention.

Chief Banda, attended the monitoring meeting, 2006 (fn.c3), some months before his chiefdom shuld arrange their planning workshop, and he brought the same views to attention in the meeting when he said; Chair, Training is a need. Who should do the training we are crying for? Here are my comments to debate: The demand is here, for MOE to take it on! To sum up the way forward: networking through strengthening the existing structures, teach our teachers, commitment, implementing what we have planned. He continued; there is a lack of literature, training, knowledge. I suggest: sensitization seminars for civic leaders, availability of brochures, booklets, posters, adequate funding to succeed so that they all can go into grassroots, (a) need for line ministries to meet, stakeholders should liaise, both traditional and civic leaders, adequate logistics and manpower is needed. The Chiefteness (fn.c1) also pointed to the importance of empowering the people in villages when arguing that, teachers, school and traditional leaders could help them as well. We need to train people in the community. Cultural awareness rising is needed, schools, community, parents, all together.

Training and capacity building were highly prioritized by the stakeholders as a way of closing the information gap. The School Community had to do what they were assigned to do, and the traditional community should work together through close collaboration and coordinated actions and follow up within their structures, is was agreed. The teaching artifacts and means were scarce, but the recommendations came out strongly about bringing in relevant and localized content and utilizing teaching materials that met the needs of the various target groups.

They all experienced the lack of resources from the MOE to support the HIV/AIDS prevention activities. Specifically, they identified the need for human and financial resources, capacity building and training on HIV/AIDS prevention, as well as guidance and counseling support. It was also a common view that by


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making HIV/AIDS education mandatory as a timetabled subject it would discourage the pupils to relate to such activities, as a female teacher expressed it (fn.c2). Referring to the issue of unprotected sex and prostitution. Importantly they insisted that funds and resources for HIV/AIDS prevention activities had to target traditional leaders.

There was an urgent need to explore ways of working together across existing borders and the participatory approach seemed to enhance and endorse this collaborative way of working. The attitudes and inputs from the different participants and stakeholders will further illustrate these new strategies, e.g. objects of activity (Engeström, 2001, 2008).

School-community relationships

The importance of involving the chiefs has been discussed previously. However, their customary duties also included developing their kingdoms, keeping customary laws and regulations as well as sanitizing the villagers in their communities. One of the contextual realities was addressed by one of the chiefs himself (fn.c2); Illiteracy among parents is a big problem, where the additional information channels are scarce, as external donors, newspapers, media etc. and where there traditionally also is a barrier between the schools and the parents. Therefore, he emphasized, we need a system to ensure that the rural areas get information from the chiefs and HM. High illiteracy levels and the poor socio-economic situation among villagers were reiterated by the chiefs, confirming what was revealed in research by Save the Children (2004) and further confirmed during the project interventions. To reach out to the parents with HIV/AIDS information, the best way, the chiefs argued, would be to use the chiefs’ structure - the traditional and oral channel for mediating information and knowledge, which historically have been the information-sharing channels in Sub-Saharan Africa, (Ngara, 2007, Taarn, 2004).

Chief Banda (fn.c3) identified these barriers, while also identifying some change over the last few years when, at the monitoring meeting in February, 2005, stated that, my niece (local HIV/AIDS advisor from c1, 2002), said children now could open up. But they are not supposed to talk about sex. We are not used to that in our country. We at home say don’t, don’t talk. The schools say talk, about … this. At school they open up, coming out…and close at household level, in terms of sex education. I still have a problem with this, talking to my old daughters. I used to go into my bedroom when they talked about sex, it is insulting. We have a problem when it comes to open up, and we close down. The traditional barrier between the schools and the parents (Serpell, 1986) adds to the importance of using the traditional structures actively in fighting the epidemic, where the local leaders would work hand in hand with the school, and at the same time sensitize the parents through their own structures. Darnell and Hoem (1996) also underscore the importance of a set of common values and interests between the home and the school, and how it affects the learning environment of the pupil:


The degree of integration between an entire system and its subsystems will determine how and to what degree the systems will function…Where there is cultural homogeneity or complementary relationship between the home and the school, each will reinforce the other. Conversely, if the cultural background of the students and the culture of the schools lack symmetry there will be conflicts.

Where the cultural influence of the school is opposing or conflicting with the students’ traditional upbringing it tends to weaken the self-concept and identity of the students. Where the content and value system is seemingly irrelevant and contradicting their socialization within home and community, the consequences are de-socialization, and in some cases, resocialization will occur. As revealed in Serpell’s study (1986), these processes are also creating dysfunctional roles of schooling which are characteristic of the situation in many rural communities in Zambia.

Teachers’ employment and transfer was a national responsibility, familiarity to the local culture and languages was not required, which alienated the parents and the community from their local school even further. This aspect illustrates the importance of the Chiefs’ involvement, and their contribution in schooling of the children including HIV/AIDS prevention activities.

Making HIV/AIDS education prevention mandatory was endorsed by everybody and viewed as one important step in the right direction. Due to the cultural taboos, stigmatization, and belief in witchcraft, the implementation would require that everybody joined forces. The chiefs and their governing bodies, they argued, would target the villagers both parents and students in collaboration with school officials. In this approach, there was a greater likelihood of a consistency and complementarity of information and messages on HIV/AIDS through the home and school.

Role of the schools

A serious complaint in regards to the role of the teachers came from the pupils themselves when they questioned the legitimacy of being taught HIV/AIDS prevention by their own teachers. One argued (fn.c1) that, Some teachers may pretend to be caring about the disease of HIV/AIDS, but when they go home, they have to go and meet some girls and make them pregnant, they forget that they are increasing the number of the disease HIV/AIDS. As long as the teachers also violated their pupils, misusing their girls and acting immorally, a pupil questioned their teachers’ legitimacy. This issue was also raised by a Chief Zimba (fn.c2) arguing that; Sexual abuse where teachers are misusing the girls should be met with penalties rather than negotiations about a fee being paid out to the parents!

In an open and straightforward way the pupils pointed at the important societal challenge, illustrating the unequal power balance, and an abusive practice whereby those in certain positions, even their own teachers cannot be trusted.


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Their legitimacy as knowledgeable teachers was questioned and the pupil (c1) suggested that, We need knowledge from specialists.

Abusive behavior and misuse of children and adolescents, even at school, as documented by Women Watch (2003), turned the schools into a risky area for some children, especially the girls, with the negative impacts on their schooling in general. A headman (fn.c2) gave an example from his neighboring school, where a young girl was abused by the teacher. As the customary laws also approved a local solution based upon negotiations, the teacher ended up paying a fine to the parents. The customary laws actually work against the legal Zambian laws.

One DEO (fn.c1) urged that, the existing policy now is enhancing HIV/AIDS education as a crosscutting issue. HIV/AIDS could be a topic coming out specifically, as a subject of its own also at MOE policy level, as was supported by the lecturer saying that (fn.c1), it should be a subject on its own. This approach is not what is said to be the national strategy emphasizing the topic as a cross cutting issue (MOE 2002, 2003).

The DEO further informed the participants that, now we have an education policy stating that 10 percent of curriculum is localized: at this workshop, we would like to see that that 10 percent of the curriculum should be dedicated for HIV/AIDS. According to the teaching service commission every first 5 minutes (of class) have been dedicated to HIV/AIDS! The main strategy is utilizing the already existing structures within MOE, she underscored. We have the structures and responsible persons, expecting strategies to enhancing the already existing structure. She urged that the curriculum should reflect the skills needed in the society.

One pupil (fn,c1) argued that we can reduce the number of infected people by sharing information on HIV/AIDS with our friends (and)... we should advise even our parents about the disease. By using the schools adequately as vehicles for HIV/AIDS education, one could basically also reach out to other beneficiaries through informal channels through interaction, sharing and learning, using it as a social vaccine targeting the communities at large (Global Campaign for Education, 2005, Kelly, 2000).

The structures were already in place, and an increasing number of children had access to schooling, (MOE, 2002, 2003). Policies were in place and approved, a syllabus and adequate teaching material (MOE, 2002, 2003) were available. But as revealed in chapter 8, the existing gaps and contradictions between the policies and the actual situation rather confirmed the inertia (Global Campaign for Education, 2005) rather than revealed optimism. As can be seen the voices of the stakeholders, the participants, wanted to make a change, and were all identifying possible solutions to the existing situation. HIV/AIDS education, it was concluded, should be mandatory, but in addition, they would utilize the 10 percent of the localized curriculum and assign that for HIV/AIDS education, timetabled as any other topic.


Societal change and western influence

The principals argued that penalties and punishment should be the response where misuse and abuse were taking place, as expressed by one principal (fn.c1), Heavy penalty should be given to people who infect others, especially the young ones, deliberately. The civic leaders (fn.c1) also clearly admitted that Lack of morals (e.g. promiscuous sexual behavior) in different spheres: homes, churches, workplaces, had to be prevented.

The main role of the civic leaders in fighting HIV/AIDS, was written down on flip chart, (2002, c1), “Our main role is to provide policies which will regulate people’s activities. E.g. taverns/night clubs should be prohibited for youth patronage below the age of 18 years, restrict truck drivers from straying into the compounds, monitor houses used as brothels, collaborate with police and the judiciary to hand down stiff punishments on those who willfully infect others” (Work shop, c1). Thus, civic leaders brought in issues related to law and order, punishment, regulations and judicial aspects sexual abuse, another important part of preventing the spread of HIV/AIDS in the Zambian context.

One of the teachers linked sex and prostitution in the following way, (fn.c1); this is a generation of sex, e.g. clothes, media … part of the democracy. Maybe Zambians have lost its culture, from legs to belly is a secret part of the body, we said before. We accepted breasts for feeding. When we now see legs, hips we are steering. Implicit in this teacher’s remarks was a blame on westernization and modernization, and impulses gained from the media. The teacher suggested that modern dress codes were contributing to the loss of the Zambian culture. One teacher (fn.c1) addressed the same issues from a more global perspective, stating: We should appreciate our culture, including respecting the culture of others. This teacher opened up for respecting otherness, going beyond the traditional mistrust of others as argued by Inglehart (2005), and showed how interaction and exposure, knowledge development, can, contribute to new ways of viewing the world, contesting and going beyond traditional cultural views.

Chiefs argued that the growing immoral behavior among youth should be discouraged so that, as stated by chief Zimba (fn.c3), Youths must be encouraged to avoid idling and embark on profitable activities in life, one should discourage children and youths to avoid early sexual activities, he continued. These inputs exemplify societal changes and discourses going beyond what a school curriculum can tackle. They would require close collaboration with a broader group of stakeholders in order to grasp the reasons for different developmental tendencies and behavior change caused by what often was termed, westernization or modernization.

The inputs to this and similar debates and arguments show that changes do and may happen, as discursive manifestations, but not as actual inputs to new objects of activity, and would therefore not be characterized as expansive learning, according to Engeström (2015). In this case, the causes and possible solutions were viewed and interpreted differently. Change and diverse views are part of how the global and local discourses were reflected and contested locally, i.e., contradictions between traditional and cultural ways of behaving, and new and emerging influences and trends.


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Urban/rural divide

The urban and rural divide was specifically raised by representatives from PTAs and Education Boards, specifically related to the uneven distribution of resources (as also documented in the baseline survey). In this context, one PTA member (fn.c1) related it to: Absence of interest stakeholders in rural areas, e.g. Voluntary Counseling and Testing centers (VCTs). Furthermore, they noted the lack of efficient and effective communication system in rural areas, of logistics, transport and funding and as well as necessary materials. One parent (fn.c1) argued that the overall impact was the, lack of skills which also leads to lack of attention to the pandemic as such by the community members.

The practical problems linked to reaching out with support to remote areas as addressed here by the PTA’s members is of general concern. One suggestion raised from one of them (fn.c1) was that, provision of motor vehicles, Hondas and/or bicycles for use in visitations, workshops. Their concern was addressing the challenges experienced related to transport and connectedness, where a solution might require extra resources. Most of these suggestions were costly and far beyond the resources allocated through this intervention, but the request is of course timely, and better communication and transport services would be a great improvement in many rural areas.

One parent also raised the issues addressing voluntary testing and councelling opportunities and practices, arguing that, teachers and others do not visit VCT centers (and also that) there is a lack of) VCT centers in rural areas. This situation makes it difficult for people to access adequate information about the epidemic, about their own status, and possible ways for them to mitigate it, or actually live with an HIV infection. Misconceptions, stigma and taboos were instead guiding peoples’ lives, and it created a fatalistic attitude to the situation. A lecturer told me after having lost 30-40 kg, I am so afraid of my own health condition that I do not even have the courage to go and test myself (lecturer, fn.c2). Without knowing one’s status, not having sufficient information, the lack of VCT centers, it all put people, specifically in the rural areas at risk, and limited their access to information.

This illustrates the need for capacity building and information sharing, openness and strategies to combat the epidemic. The inputs made the program coordinators able to argue for strengthening the efforts, at least among the MOE employees, to get information and access to VCT, which turned out to be an important component in the new object of activity.

8.3 Impact on culture and traditions As Gyekye (1997) argues, only by questioning the existing situation, can the next generation decide upon whether or not existing traditions and practices, should be inherited and applied to their own generation, or not. Questioning and


reflecting is the first step that can contribute to change. This reflects the input from one of the influential chiefs, chief Musonda (fn.c1). The chiefs’ spokesman, spelled this issue out clearly: certain traditional and cultural beliefs which are a hindrance to fight against HIV/AIDS can be discarded, for example, sexual cleansing. The chiefs present at the workshop were ready to contribute by discarding and changing certain cultural practices, in spite of being the custodian of traditions in their chiefdoms. They were suggesting that certain traditional and cultural practices “could be discarded” which actually suggests that at least one deeply anchored and ongoing cultural practice should be abolished. The chief specifically identified one of the mediating tools, a tertiary artifact, and the cleansing rite to be discarded as it was considered a driver of the epidemic.

As the chiefs actually took on the perspectives and views of some of the presenters, instead of defending the existing cultural practices, they were the first group of stakeholders to openly suggest the discarding of some of the rites. At the same time they questioned certain traditional beliefs in relation to HIV/AIDS. The attitude and commitment employed by the chiefs were in a way setting the scene and certainly contributed to the openness that characterized the rest of that and similar planning workshops.

Their ideas, as well as inputs from the other groups was displayed on flip charts along the meeting room wall. During the days to come, the walls were fully papered with inputs from the various groups’ work. The result, the “talking walls” reminding and inspiring everyone to reflect, interact and take an active part in the discussions on possible ways forward. The workshops were facilitated to explicitly mediate the various activities during the workshops, the sharing of information from different actors, perspectives and lenses, through group-work and plenary sessions. But as the participants also spent days and nights interacting with each other, during the informal settings, they implicitly also discussed, shared and exchanged views on the topic for discussions.

After the chiefs’ presentation, other stakeholders followed up with inputs to the plenaries. The viewpoints varied by age, profession and societal position, but the most frequent and main inputs to the discussions are illustrated next. The chiefs’ ideas coincided with the voice of one of the representatives of the groups of primary and secondary level principals. It was emphasized that (one should) renew Zambian culture and traditions to harmonize with modern culture. The cultural traditions and practices that would enhance the spread of the disease should be reviewed and changed. The term “modern culture” is here referring to input from the presentations, the knowledge on the main drivers of HIV/AIDS, the baseline info regards HIV/AIDS education, as well as academic and scientific input to possible prevention measures and strategies in their districts. Their suggestions and recommendations to review practices enhancing the spread of the epidemic, and thereafter take the necessary steps to change them, were an important step towards the construction of a new and more advanced prevention strategy, where old knowledge was harmonized and merged with what was


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termed, modern culture. This process exemplified a horizontal sharing across existing epistemologies.

The principals highlighted polygamy in their presentation, the presenter said (fn.c1) (there are) difficulties with some communities due to certain traditions, some communities are difficult, polygamy, (they) will keep on to that tradition. The drivers of the epidemic, as described in in Chapter Three, also being a part of the HIV/AIDS content to be taught according to the recommendations and issues from The Interactive Manual on HIV/AIDS Education (MOE, 2003) were openly addressed, discussed and brought up by different stakeholders. The workshop’s open discussion about HIV/AIDS revealed the problematic contradiction between the traditional and cultural beliefs and practices and safe sexual behavior. Beliefs related to the spiritual world e.g. witchcraft, which according to many informants were to be blamed for contracting HIV/AIDS had to be replaced by scientific knowledge. This view was supported by the principals and college lecturers, focusing on the need to assess which traditions and practices had to be transformed or eliminated in order to prevent the spread of the epidemic when understanding the scientific explanations for contracting HIV/AIDS.

Taboos versus openness

People rarely talked about HIV due to the cultural barriers controlling what can be said in the open, and by whom, specifically in relation to sexuality and adulthood, (Aggleton, 2005, Gausset, 2004, MOE, 2002, 2003, Ngara, 2007, Women Watch, 2003). As a consequence the misconceptions and ignorance on HIV/AIDS were flourishing at all levels in the society.

One needs to help communities in general to break communication barriers and talk about HIV/AIDS freely, one DEO representatives argued (fn.c1). This was followed up by the representative from the principals, stating that; traditionally (it is) not acceptable to talk about private parts.… Sexual organs are difficult to talk about in the community (fn.c1). The children characterized the present situation and their spokesperson said, there is a lack of sex education from our parents. Our parents should stop talking about traditional laws and start talking to us about HIV/AIDS. (They should) inform children about HIV/AIDS so that they can pass it to the next generation. The group of parents supported these views as well and underscored that one had to break the barriers including taboos, in the cultural flow of information useful to the fight against HIV/AIDS.

The pupils also addressed the cultural tradition regulating what the parents were allowed to talk with their children about. One said that the parents now did not talk about “these issues” with their children. In the Zambian context, there are special persons (usually the elderly) in the villages assigned to perform certain rites, to introduce the children to adolescence and adulthood, through initiation rites.


The children emphasized the need for their parents to bring up issues of relationships and sex with them. This exemplifies another cultural rite mediating and controlling artifact in peoples’ lived world (Cole, 1998). The cultural artifact mediating the rules for upbringing the children, is a barrier that restrict the parents to take action and inform their children about HIV/AIDS, the drivers and the impacts of the epidemic. It is a cultural taboo. At school, according to the student teachers were unable to teach about HIV because of these barriers. As illustrated, this situation reflects a primary contradiction within the domain of tool-mediated learning, between the culture denying openness, from a traditional perspective and the schools mandate to, emphasize openness, based upon Engeström’s concepts (1987, 2001). The solution to this double bound during the workshop was a cry out for openness, within both activity systems.

What the pupils actually also suggested was to change a tradition that had been practiced over generations in the African extended household, where the saying is, “it takes a community to raise a child” (Ngara, 2007). The upbringing process includes rites and schemas assigned to different people in the community. The initiation ceremonies, where girls are taught about adolescence and adulthood, roles and expectations, is where sexuality is being addressed, and these ceremonies are conducted by selected elderly women, (see Chapter Three). The pupils suggest a change of a traditional mediating artifact, the initiation rite, a tertiary artifact according to Wertsch’s (1998) categories.

“Opening up”, start talking about and discussing HIV/AIDS, drivers and impacts, even though breaking the cultural schemes and rites, the taboos, was supported by the participants. Based upon the shared facts, the contextual realities and the impacts of the epidemic, the participants saw it as crucial to openly discuss issues related to the epidemic in order to mitigate the disease.

Stigmatization

The issue of stigmatization was raised in different contexts during the workshops. One teacher stated that (fn.c1) the women may be jumpy, bringing it (the virus) to the home. Women attract men. They are responsible for the problem. Men cannot control themselves. Another teacher added: gender issues, especially the freedom in dress code, moral corrupting TV and Radio programs (fn.c1). These voices represent the parents’ perception when discussing immorality in the context of HIV/AIDS. The Mayor contested the stance of blaming women and was supported by chief Musonda, who stated that, from poverty, our women are forced into bad activities (fn.c1).

One parent (fn.c1) brought another perspective, suggesting that one should accept HIV/AIDS as any other disease and openly discuss it. The disease, HIV/AIDS, is in itself being conflated with a taboo, associated prostitution and sex work, and thereby stigmatizing the whole family. That creates silence and people do not talk about the disease, which also obstructs care and support to those infected.


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A principal complained about the same attitude, where people restricted themselves from, as he said, talking about care and sick, some do not want to protect them (fn.c1). The discrimination of those infected, and the lack of support to the sick ones, further reflected how the existing cultural norms prevented people from even showing empathy and giving care and support to PLWHA. One pupil also raised this issue when referring to openness, it can be easy to help people living with HIV/AIDS by living a positive life (fn.c1). Her stance was rather to support and help those infected, instead of meeting them with skepticism and stigma.

The way the participants expressed attitudes of stigma regarding care instead of acceptance and tolerance, illustrates how people adapted and internalized the traditions handed over from their ancestors. At the same time, other voices contested existing practices, by questioning the culture and issues within the regulating power of the traditions in the communities. In this context it is the questioning of old and existing practices (also exhibited by participants in similar contexts) which led to the contestation of inherited norms and rites. The questioning, is where changes start (Engeström (1987, 2001, 2008, Guykye (1997). During the years of this intervention, the questioning seemed to be strengthened where the actors participated in homogenous groups. It seemed to empower the voices of each group of stakeholders eabling them to speak up and share their views in the plenary sessions.

In the following sub chapter, the prevention strategies that evolved from the workshops are explored in relation to the domain, the division of labor, and roles and responsibilities assigned to the different actors in order to implement the new object of activity (Engeström, 2001).

Customary laws and penalties

Principals further argued that penalties and punishment should be the response where misuse and abuse are taking place, Heavy penalty should be given to people who infect others, especially the young ones, deliberately (fn,c1). The testing in itself is controversial. One HM and former principal informed the team during a meeting (fn.c3) that where foreigners were running and conducting the testing, many villagers did not trust their confidentiality, and as a consequence they did not go for testing. There were also few opportunities for testing in general, specifically in the rural areas (f.n.c1, c2, c3). For these reasons, those deliberately infecting others were not easy to identify or prove. Another HM (fn.c2) working in Chief Musonda’s parliament argued that where teachers are misusing the girls they should be met with penalties and not as now, where they rather negotiate and agree upon a fee being paid out to the parents!

One pupil (fn.c1) bought this issue up even stronger stating that: We want teachers who make school-girls pregnant to be punished or to be charged. As long as customary laws still are being used where the tradition allows it, customary laws have a legal status in the Zambian law system as a parallel judiciary system


(Women Watch, 2003 and chief Zimba’s parliament, 2004, c3). These struc-tural, legal laws were beyond the scope and jurisdiction of the project itself, but considered as issues to discuss locally by the participants.

As explored in previous chapters, the subordinate role of women, children and orphans, the fact that they are not in a position to negotiate sex, and actually have difficulties with getting their rights approved through the court system in spite of official laws, makes this a very important aspect in fighting sexual abuse and misuse of women and orphans. Reducing the availability of alcohol and drugs by restricting the adolescents to access bars late nights will also indirectly reduce possible HIV/AIDS transmission through immoral behavior.

8.4 Impacts on MOE activities

Monitoring and evaluation

The education managers were addressing the need for appropriate knowledge and data to help them in, Research and data collection and interpretation as argued by the DEO (fn.c1). The managers also clearly underscored the need for effective monitoring and evaluation strategies. Civic leaders indicated the need to decentralize the functions to grass roots level. A representative from the college (fn.c1) presented their possible role, e.g. the Monitoring of activities in schools….done hand in hand with already serving teachers, (through in-service training). The role of District Education Officer and District Insert Providers, the Management, (he continued should be) Management and material support (including) Initiate training programs on HIV/AIDS.

This was supported by Chief Banda (fn.c3) suggesting that, the delegates to be invited later, to evaluate. Those who have been assigned tasks should report back, identifying structures, how to support infected people in rural areas. The Civic leaders should Inform and sensitize all civic employees, information is needed, there is lack of adequate funding and lack of coordination between line ministries, lack of morals in the different institutions, immorality!

One agreed the importance of developing a monitoring and evaluation system that could build new knowledge based upon and experiences from the different locations, enabling the districts actors to learn from each other through shared monitoring sessions. A monitoring scheme was developed involving one representative from the PEO, DOE, a teacher college lecturer, a school principle and the external expert/researcher. This was piloted after the first year program implementation, thereafter revised and turned to be a useful tool for in depth discussions and shared learning in the years to come. Different types and ways of learning took place at work, within and among the core people involved in the project, through different activities, functioning as spaces of learning, e.g. induction or introductory workshops and meetings through the formalized annual monitoring and evaluation meetings, as well as through school monitoring and supervision, and the school and community interventions.


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Teacher training The lecturers suggested (fn.c1) the need for In-service training on the use of teacher’s guides to support the teachers and enable them to teach HIV/AIDS in classes. Another added that, Sensitization of the Board and Parent Teacher's Association Chairperson on HIV/AIDS who (then) in turn will disseminate the information and consolidate it to the community (fn.c1). He continued, Sensitization of chiefs, headmen/women and Civic Leaders is needed, in order for them to take on the responsibilities as suggested regards information sharing information and consolidate it to the community. Chief Musonda also recommended that Parental Guidance and HIV/AIDS to be part of school curriculum (fn.c1).

The lecturers also required concrete actions to be taken at school level, aimed at strategies that also could reach out beyond the classroom level, which confirms the importance of a closer relationship between the HIV/AIDS education at school, and the HIV/AIDS discourses addressed in the pupil’s homes. The lecturers argued for reaching out with adequate information to the parents, underscoring the general lack of adequate knowledge on HIV/AIDS among community members. The teachers also underscored that need for a close networking between the schools and the parents, and supported the issues brought up by the chiefs.

The importance of being good role models was also raised, and a DEO (fn.c1) highlighted it as follows: (we need to) be good role models, to have a positive common attitude. All participants in the workshop admitted that there were practices and attitudes among adults that had to be addressed and changed as well, and underscored the importance of be good role models for each other and the students/pupils/children we are educating. A PTA member (fn.c1) also contributed by adding that, being open, sensitizing the child and be good role model was something that should be emphasized also by the parents.

These inputs towards the establishment of a new in-service training program where not only teachers were targeted but also involved the chiefs and parents were important contributions to how the capacity building and in-service training later on were developed.

8.5 The new objective of activity The priorities and issues addressed by the different homogeneous groups clearly show the importance of allowing different stakeholders to engage in dialogue in order to find solutions to their own problems and needs, without interference by others. The situation, interpreted from different angles, through different perceptions, clearly shows the representation of different worldviews. The children, the parents, civic and traditional leaders and MOE-staff at various levels, all contributed on a range of important issues one from multiple perspectives when discussing the complex and multisectoral issue of preventing the spread of HIV/AIDS.


Each of the individual groups presented and gave reasons for their understanding and solutions, and shared it openly with the other participants. By first having dialogue among equals, it enhanced an openness and supported a multi-voiced response. The homogenous groups also play a role in reducing the power dimension among the group members, in the sense that no one necessarily had a superior and dominant voice in the individual groups. Through an agreed presentation, where the various components were prioritized and argued for, the groups empowered themselves by being able to present their final result.

By sharing the results in plenary, and through interaction and discussions, gradually the complexity of issues involved was brought out in the open. The process created a common understanding of the complexity of the issue as viewed and discussed from the various perspectives.

The impact of this is further explored in the minutes from the same work shop, “Conclusions to be drawn from this workshop was quite useful in the sense that the stakeholders of different ages, status, and background interacted and shared the common views of interest on the killer disease, HIV/AIDS. It was an eye opener in a way especially to those handling young children. The voices of children were the loudest as they challenged the parents, elders in civil and traditional society” (f.v. college tutor).

The experience as revealed through these planning workshop, where dialogues and negotiations between the different participants, the new object of activity, here, a localized HIV/AIDS education prevention strategy was discussed and transformed into a “new and more advanced object of activity” (Engeström, 2001) through collective movements. The complexities of the object were envisioned and by questioning the actual empirical findings and traditional practices, primary and secondary contradictions, including double bind situations, were identified. New knowledge was gained and used to illustrate risky behavior, or practices that should be abandoned. Through such an expansive and social learning activity, the processes revealed how people faced and lived in the context of HIV/AIDS.

The whole process turned into a social learning process for those being involved. Based upon the findings revealed in the baseline survey, the inputs from the relevant actors, a needs assessment were undertaken by the various participants. Through discussions and negotiations, the participants created a common vision for new actions that should be taken. Similar learning cycles is characterized as expansive learning process, in Engeström’s (1997, 2001, 2008) terminology. The new and more advanced object of activity was developed and agreed upon through a multivoiced process that in this specific context was related to a localized and situated HIV/AIDS strategy within the overall MOE policies and strategies.

After having shared and discussed the different contributions from stakeholders, taking into account the information from the presenters, the heterogeneous groups finally came up with a shared vision that included most of


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the issues being addressed by the various stakeholder groups. The conclusions below are taken from workshop official minutes taken by the secretary.

“From the outcomes, the participants agreed on the following needs: � There should be collaboration among different stakeholders of

various levels in order to enhance the fight against HIV/AIDS. � Financial, material and moral support should also be directed straight

to local communities where the neediest persons were found. � The child must be capacity built on HIV/AIDS in schools, target

behavioral change processes. � One should equip the people with the basic knowledge needed for

health and positive living. � Emphasize to educate people on the need for behavioral change

and facilitate sensitization activities at all levels. � Breaking the barriers in cultural flow of information useful to fight

HIV/AIDS. � Also censoring cultures and traditions for the purpose of identifying

and keeping only those that are useful” (Minutes from the workshop, secretary, 2002).

The recommendations were guiding principles throughout the project period. In 2006, the approach was applied in all districts. The guiding principles were rooted in a participatory and situated paradigm, Freire (1996), and Engeström (1987, 2001, 2008), reflecting the local contexts and needs (Serpell, 1998, Darnell Hoem, 1996). As Collins (1998) argues, these processes are closely related, and emancipatory. Smith (2007) further elaborates on similar approaches referring to a decolonizing approach, whereby people’s voices are recognized and are equal partners in their own development. In addition to the principle of a broad stakeholder involvement, networking, collaboration and coordination between different professionals, across the existing boundaries, in Engeström’s terms, border crossing, introduced a new approach to HIV/AIDS prevention strategies. Coordinated by a team of 3 MOE-employees, one at province, district and school level, in addition to the external expert the school-community driven approach was targeted at teachers, pupils, parents and villagers. It involved traditional and civic leaders, the education sector and schools, NGOs, churches and health clinics. The ISACA approach mediated and facilitated through workshops, meetings and field visits, created spaces for interaction and dialogue (see chapter Eight Methodology). This approach legitimized the education sector with its collaborative partners as a “social vaccine” in the fight against the spread of HIV/AIDS (Global Campaign for Education, 2005, Kelly 2000).


8.6 Summary The chiefs, the spiritual leaders, were acting as the significant other, as defined by Wertsch and their contribution proved to be an important mediating tool or artifact in the HIV/AIDS prevention approach analyzed in this study. Their role in giving permission to break cultural taboos and in leading the transformation of cultural artifacts and tools in the service of preventing the spread of HIV/AIDS and caring for those with the disease informed the central themes of the approach. The existing worldviews and cultural norms and traditions characterized by Cole (1996) as secondary artifacts, including the taboos and the stigmatization of those breaking these, were viewed as the key constraining factor in mitigating HIV/AIDS. By leading cultural change important for reducing the drivers of the spread of HIV/AIDS, the target audience was free to open up and participate in the approach to HIV/AIDS prevention that would ultimately lead to behavioral change.

By questioning and contesting the initiation rites, and challenging the parents to discuss sexuality and HIV/AIDS with their children, the role of initiation with rites that put young people at risk of contracting the disease were changed, and in some cases eliminated. As parents’ participated in the approach, were more informed, and gained permission from their traditional leaders to take responsibility for their children’s growth and maturation new cultural patterns emerged.. Gyekye (1996) argues that transformation and cultural change occurs over time, but the first step is for a generation to question the value of the traditions and practices itself. In this debate, that is exactly what the participants did. Contribution of the various stakeholders, including the pupils’ inputs, shows how powerful such a horizontal and vertical learning actually might be.

Cultural and traditional protocols and norms were adhered to in these processes based upon involvement and the voices of the different actors themselves, reflecting their epistemological lenses when negotiating and agreeing on common vision of the new object of activity. In so doing, the chapter shows how horizontal interaction across traditional boundaries and activity systems can contribute to cultural border crossing, new innovative practices and cultural and educational transformation.

Through the facilitation the participants engaged in actually “voicing and naming their world”, where they collaborated in terms of their “here and now”, their present, existential, concrete situation (Freire, 1972 in Collins, 2011, p.105). Such a process contributes to an active conscious engagement changing both the world and the acting subject in an emancipatory direction (ibid. Chambers and Pettit, 2003). The inclusive and participatory process further illustrates what Smith (2007) describes as a decolonizing approach where everybody was enabled to take the perspective of the other (Hoppers, 2001).

The views and knowledge presented by the various participants, from the traditional leaders, the MOE employees, NGOs, pupils, teachers, parents, professionals and novices during the introductory workshop (s), created a


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learning situation where traditional knowledge and practices were challenged and contested in the context of new knowledge of HIV/AIDS, its drivers mitigation strategies, education policies and practices. The learning process illustrates the first steps in an expansive learning cycle, as it is termed by Engeström (1887, 2001, 2008), and explained in Chapter Seven.

The participants were questioning the existing practice regarding the spread and prevention of HIV/AIDS, they identified primary and secondary contradictions based upon knowledge sharing, discussions and negotiations, and came up with ideas, that were modelling a new solution to combat the epidemic in their own districts, developed a new object of activity.

It was agreed that MOE, through the HIV/AIDS coordinating team should coordinate the intervention, ensure the close collaboration between the partners from the two activity systems, including possible other local partners. The school-community- as well as the traditional community activity system, the core collaborating actors should, through their institutions, organizational bodies and relevant stakeholders, be utilized as a social vaccine to mitigate the impacts and spread of HIV/AIDS. Financial support should also be channeled from MOE central level to the local schools. A core requirement was to capacity build children and adults on HIV/AIDS, target behavioral change processes and equip the people with the basic knowledge needed for health and positive living at all levels, using the schools, educate people on the need for behavioral change and Breaking the barriers in cultural flow.

The recommendations were guiding principles throughout the project period. In 2006, the approach was applied in all districts. The guiding principles were rooted in a participatory and situated paradigm, Freire (1996), and Engeström (1987, 2001, 2008), reflecting the local contexts and needs (Darnell Hoem, 1996, Serpell, 1998). As Collins (1998) argues, these processes are closely related, and emancipatory. Smith (2007) further elaborates on similar approaches referring to a decolonizing approach, whereby people’s voices are recognized and are equal partners in their own development. In addition to the principle of a broad stakeholder involvement, networking, collaboration and coordination between different professionals, across the existing boundaries, border crossing (Engeström, 1987) introduced a new approach to HIV/AIDS prevention strategies. Coordinated by a team of 3 MOE-employees, one at province, district and school level, in addition to the external expert the school-community driven approach was targeted at teachers, pupils, parents and villagers. It involved traditional and civic leaders, the education sector and schools, NGOs, churches and health clinics. The ISACA approach mediated and facilitated through workshops, meetings and field visits, created spaces for interaction and dialogue (see chapter Eight Methodology). This approach legitimized the education sector with its collaborative partners as a “social vaccine” in the fight against the spread of HIV/AIDS (Global Campaign for Education, 2005, Kelly 2000).


The new object of activity can in brief be clustered around some key principles:

1. collaboration and coordination through horizontal sharing, between actors within the two interacting activity systems, the Traditional Community and the School Community,

2. capacity-building at all levels, as the Chiefs worked vertically within their Traditional Community, from the House of Chiefs to school and village level, and MOE, through province, district and college level employees, would target the School Community.

In the next and final findings chapter, the main outcomes of the intervention, the actual implementation of the new model, and phase 5 in the expansive learning cycle are explored. The chapter respond to research question 4, e.g. elaborating on the local interventions at school and community level. The chapter explores how change and transformation manifested itself, the response of traditional leaders to the challenges presented by the HIV/AIDs epidemic, as well as the impacts on HIVAIDS education at school level.

Chapter 9

Change and Transformation

This chapter explores some of the actual outcomes of the interventions, the new object of activity, and responds to the third research question. The chapter describes the model of activity and reveals the transformations that took place within and between the two interacting activity systems. It focuses on change and transformation as it manifested itself during the project interventions through vertical and horizontal networking and collaboration. The first sub-chapter examines the chiefs’ involvement with emphasis on their role as significant other and as gate openers leading to cultural transformation. The second sub-chapter focuses on the traditional leaders’ interventions and initiatives as capacity building within the activity system levels of Traditional Community, House of Chiefs, villages and schools. The school-based interventions initiated and implemented through MOE structures are addressed in a separate subchapter. It also illustrates how the Chiefs worked horizontally supporting the school and community. The chapter identifies how cultural change within the School Community as a whole enabled the teachers to go beyond previous cultural barriers by implementing the Interactive Methodology on HIV/AIDS prevention (MOE, 2003).

9.1 Traditional leaders’ contribution to cultural transformation

Four influential Chiefs in Southern Province were key informants. They all participated in the first three cohorts of the project and subsequently contributed to the development and implementation of the project over a number of years. Their strong position and legitimacy as leaders in their kingdoms, their role as significant others and role models, allowed them to engage directly in developing strategies and prevent the spread of the disease in their own communities. This is consistent with Taarn’s (2004) research, revealing similar results. The chiefs participated actively in the intervention, working with MOE employees in close


collaboration with the core project team. They actively searched for new knowledge by taking part in the capacity building activities within ISACA, although aware of the fact that the issues for discussion related to taboos, and stigmas, were threatening their traditions and culture. One HM (fn.c2) noted; I am afraid of losing our culture. It was the engagement by the Chiefs that proved significant regards the cultural change and transformation.

During related activities in neighboring countries, Taarn (2004) found that the traditional leaders themselves developed a level of expertise and spoke out on the issue of HIV/AIDS. The voices of the Chiefs had the effect of delivering an even stronger message than gate opening, since it more closely associated the traditional leaders in the struggle against the disease (IDRC1).

Their engagement and eagerness actively taking part in modelling the new strategy went even further, as they contributed to the extension of the HIV/AIDS education prevention beyond the MOE structures. The chiefs actively took on the role and responsibility of preventing the spread, reduce stigma, and abolish risky practices through local capacity building within their Chiefdoms. These actions by chiefs is all the more powerful when considering their double bound situation as custodians of customary laws and traditions, while acknowledging the need to fight the epidemic by changing cultural practices, norms, and rites.

Traditional leaders as Gate openers

Historically, the traditional leaders in Zambia have played an important role in developing and ruling their chiefdoms based on customary laws and rooted in cultural and historical traditions. As a continuation of the colonial governing structure, the Chiefs still have their executive national body in Zambia, the House of Chiefs, existing alongside the elected democratic, public governing structure (Gersheim, 1997, GTZ, 2004). One may ask: to what extent do the Chiefs still play a role in ruling their chiefdom or kingdoms, in Zambia? Chapter Six described their historical, formal and legitimate role as leaders. In the following sections this issue will be addressed by referring to the voices and views of the different actors involved in this program as it relates to the role of, their local village chief and the HM in relation to village development or more specifically, as here, related to HIV/AIDS prevention or education.

At the headquarters level in MOE, as late as 2005, in a meeting with the focal point persons for HIV/AIDS prevention, key officers confirmed that they did not formally involve the chiefs in any HIV/AIDs prevention activities, also confirmed by the chiefs themselves. At the province level though, the senior education councilor (fn.c1) argued that: They (local stakeholders) know very well the

1 See: http://www.idrc.ca/EN/Resources/Publications/Pages/

ArticleDetails.aspx?PublicationID=761


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issues in their community. Now when we work with the Chief and the HM it makes it easier to reach out to the community at large, also to talk about cultural practices and open up on HIV/AIDS.

The DEO (fn.c1) working in the urban/semi-urban district underscored that All stakeholders are relevant partners…..including the traditional leaders. Another district officer (fn.c1) emphasized strongly; If we do not involve the Chief….we will not succeed, they are being listened to very carefully. He referred to a Chief in his neighborhood and continued, The Chiefs say, “this is my community”. The community belongs to the Chief. If not involving them means far less influence, participation and impact at community level, a precondition (education officer, fn.c1). The same message was fully empbraced by the DEO representatives in all the following cohorts of the program, from the rural as well as from the more urbanized districts, level Our Chiefs are crucial. We work with them very closely. That link is very important to reach out in delivering these messages (DEO, fn.c3).

At school and community level, the Principals also fully emphasized the importance of involving the Chiefs, one said (fn.c1): The Chiefs have been very important. Another principal (c2) put it like this, Chiefs, the first people to be involved, without HM you cannot do anything. Put slightly different a third principal echoed this (c3) Africans are tied with their own traditions, difficult to open…. The Villagers have all the respect for him and follows his orders.

A Guidance and Counselling teacher (fn.c3) also endorsed the fact that the chiefs and local leaders were involved, Head Men and Chiefs, …to be encouraged, then the information will be disseminated in the communities to show that the fight is not just in school. The school has to ensure a close collaboration with the community in order to reach out with HIV/AIDS prevention. A close school and community-relationship, where we find the parents and the pupils and any other significant villager, the elderly and those identified as initiators, will support any prevention strategies, e.g. changes through re-enforced socialization processes, support from the community as well as from the teachers and schools.

The PTA’s chairperson (fn.c2) in the board of a primary school further elaborated on the importance of a close link between the school and its local community: For the rural child, the teachers are operating in the community. We will have to cooperate with the communities. Not leaving out the local leadership. They have the authority to talk to the rural people.

As is illustrated by the quotes above, all the different stakeholders, expressed the need of involving the chiefs in fighting HIV/AIDS at school and community level, it being stakeholders involved in 2002, to those involved in 2006. Including the chiefs in the program, was, as explained by Cole (1996), a way of incorporating a tool, or an auxiliary mean, where the chiefs acted as the “very significant other”, the core mediating tool. The gate-opener role of the chiefs is one core element of chiefs’ involvement in HIV/AIDS prevention. Also revealed by Taarn (2004). The traditional leaders actually open the door to


outside advocates, lending them legitimacy or credibility in the community, and acts as gate-opener for further involvement of external actors.

Trust is an important element in collective societies, as previously discussed (Inglehardt, 2005). A couple of examples can illustrate this. A previous principal, now HM (c2) told us that an NGO came into the community to conduct Voluntary Counselling and Testing (VCT). Nobody wanted to use their services because they did not trust their confidentiality, thereby being afraid of stigmatization. An experience from a field trip, cohort 2, when the coordination team was searching desperately for accommodation late in the evening, all optional guesthouses were closed for the season. There was just one option left, a house in the district center, usually ready for senior public employees. In spite of negotiations between the PEO and the guard, he would not allow us to utilize the facilities, even though we were willing to pay whatever price, as this was our last option. He politely followed us to the gate, and then saw the accountant with her Chitenga (typical Zambian textile used by women to protect the skirt). Her affiliation to the Adventists was imprinted in the textile, and immediately, the attitude of the guard changed. She was titled, sister, they had a conversation and we were all welcome to stay in the house. Religious affiliation created trust that opened the door for us all.

Trust is essential, specifically when working in traditional societies (Inglehardt, 2005). The fact that the traditional leaders endorsed the HIV/AIDS program, and the work of the coordination team, comprising Zambians except for the foreign technical advisor/researcher, also helped the project and affiliated members to acquire trust/ be trustworthy/ trustworthiness among the community members, school leaders and within the community of Chiefs.

Vertical interventions within the traditional community

The role of the Chiefs’, also relates to how their work is organized and structured within their kingdoms. The following excerpts different HIV/AID prevention interventions initiated by the chiefs illustrate how Chief Zimba (c2) and Chief Bemba (c1) managed and organized their HIV/AIDS activities within their own chiefdoms and villages.

When visiting Chief Zimba’s (c2) palace, his prime minister was present, and I being the only outsider, was served egg, bread and coffee. Nobody, including foreigners are supposed to eat with the chief. It was therefore an honor and a sign from the Chief of trust and respect. Chief Zimba started talking:

The chiefdom, organizational structure: Royal establishment, clan for the chiefdom. Within the clan there are the chiefs. Throne from the Royal Establishment, The House of Chiefs. Each Chiefdom has the chief, then prime minister, then council, advisory committee, developing the policy. Within the policy are issues related to traditions, general development, including HIV/AIDS. Then agreed roles and


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responsibilities are agreed. Here, in the Palace, the Chief, then the chief’s council, all 23 zones are reporting to the council, through the senior HM, elected and oversees the activities. Then there are 354 village HM, also female, each catering for 10-100 households through the village committees. Every month the chief councils meet, discussing development, education and health.

Every tenth in the month the council meets. The board members come to report to the Chief. 350 villages, approximately 30000 people, 1400 square kilometers. Where senior HM come is where the chief will go organize gatherings, request my prime minister. I will try to visit each village. People are shy. The Chief will create an atmosphere of openness, enabling them to speak. HM was afraid to speak to the village directly. I usually go cycling, easier to reach them then they are alert (Chief Zimba, Sept. 2004, field notes, c2).

The structure presented confirms and coincides with the overall traditional structures as revealed by Taarn (2004) and also found in the research by (GTZ (2005). He underscores his responsibility for the traditions and general development of his kingdom, as revealed in the Chief’s Act (Gersheim, 1997). His awareness of gender equity was underscored by the chief, as they are elected as HM/W in the villages as well. The fact that the Chief specifically address the female representation also indicates that the traditional gender roles at that time gradually were turned into a more gender balanced approach, opposed to the traditional picture of general subordination identified by Women Watch (2003) and Inglehardt (2005).

He also expressed his commitment to talk to his people directly, visiting every village in his kingdom, where he stepped in when the HM did not feel comfortable to speak to the villagers directly. The Chief’s presence would help and enable the people to open up in similar cases. This demonstrates the inherited and legitimate position of the Chiefs, enabling people to open up where it would otherwise be difficult, as was the case when addressing any issue related to HIV/AIDS.

Chief Zimba concluded his presentation by saying: Every day, day to day life, people and the Chief feel programs carry weight if he is involved. If not the program failed. If the MP (members of parliament) comes, a few people will be there. When the chief comes, everybody come there (Chief Zimba, f. n. 2004, c2). Similar views regards the role of the MPs was addresses in other occasions as well, but will not be further elaborated on here. The core issue is rather how the Chief himself perceived his role and influence.


Community related HIV/AIDS interventions

At a visit to Chief Bemba’s Palace in 2005(c3) we were informed about how his chiefdom had organized their HIV/ADS activities. The story was told by a group of HM in the castle of Chief Bemba who had invited the HIV/AIDS coordination team to come to visit his castle February, 2005, after being involved in the project in spring 2004, cohort 3. The following information was summarized from the field notes after that visit. Unfortunately, we came a bit later than expected and the chief had left for a meeting in the House of Chiefs. Representing Chief Bemba was his senior HM:

There are 200 villages in the chiefdom. We see that the HIV/AIDS rate is going up. The Chief called upon people from the kingdom to establish a HIV/AIDS task force, and discussed how best to combat HIV/AIDS. The meeting was convened at the Royal Palace, June 13th (2005). A committee of 16 persons was established, comprising of chairs for the different subgroups, secretary, treasurer and committee members. Involved were also healers, a person from the ministry of health, NGOs, business-men and agricultural activities. All 16 are drawn upon from the 11 fields, e.g. groups of villages in the kingdom. We have a main committee, a sub-committee, a committee for planning and finance including one committee for dissemination of information or sensitization. The Chiefdom has a senior HM, the Villages [have] their HM, including a senior HM task force, then village HIV/AIDS task force. Structures are in place [He went to pick the minutes to show us!]. A work plan is agreed, and the committee has met 5 times (Field Notes, 2005).

The excerpt above describes how the Chief in this kingdom had organized the various activities. Structures were in place, the core committee represented a diverse group of people from the kingdom, and they actually emphasized, while looking at me, smiling, that they were gender sensitive and had an equal representation of women in the committees. This was confirmed from the minutes of the meetings he handed over for me to read. The HM continued his presentation by informing us about the actual activities initiated, and explained, We have e.g. identified orphans, mitigating problems, and discussed sources for infection like; widow cleansing, gatherings, promiscuity, importance of having youths attending recreation activities. This in order to avoid drinking beer, becoming promiscuous (fn.c3).

The HM further told us that they had a community structures in place, action plans and routines for how to report and coordinate the different activities. From 5-21 September, 2004, sensitization was carried out, and on 27 September, the same year, the abolishment of bad habits was declared. He continued:

We want to have a VCT center established, no funds still yet in place. Impact of the work so far: awareness is increasing; stigma is not as big now. Girls’ abuse is talked about in the open, something that could


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not be talked about when male was around before. Declaration in the fight against HIV/AIDS (from the Chief) sexual cleansing - by proxy- kuhuta, (women to women) or bathing in herbs.

We now ban early marriages, ban practice by herbalists and traditional healers where they have intercourse as payment - or virgins, to cleanse HIV/AIDS. Death of husbands, widower inheritance only after VCTs, encourage VCT before marriage, discouragement of polygamous marriages (common, cheap labor when producing maize), orphans need support systems, practice of dry sex discouraged, initiation ceremonies should include gender roles, human rights and equality, lobola (bride prize, thereby enslaved for lifetime), should not be commercialized witchcraft is discouraged. All is pronounced by the chief: If anybody says they can cure aids, they should be brought here (to his Palace). Everybody knows the view of the chief. Healers are joining us very slowly. They are using razor-blade twice or more, difficult to get rid of. If somebody is infected, the healers use to blame it on witchcraft (Field Notes, c3, 2005).

This story, and the minutes from the meetings, describes some of the HIV/AIDS prevention interventions initiated and implemented in the kingdom of chief Bemba. The HM claimed that people were opening up and that stigma was being reduced. Cultural practices as sexual cleansing was gradually being replaced by new cleansing procedures, e.g. women to women; herbal baths. They further informed that polygamy and lobola was discouraged. The Chief also encouraged the inclusion of HIV/AIDS into the initiation ceremonies, an approach also supported by Dr. Phiri in The Post (2005). Gender equality enhanced and misconceptions related to the spread and cure of HIV/AIDS, e.g. witchcraft as a means abolished.

At a visit to Chief Zimba’s palace (2004) a similar story was told. This small quote is selected as it shows how the different chiefdoms, through internal discourses and negotiations within their parliament found their own solutions to the challenges they were facing. They applied traditional ways of reaching consensus within a kingdom using traditional, local protocols. The HM told us, Cannot change overnight, cannot change immediately. Condom use, they know it. Traditional (sexual) cleansing is away. One of the main obstacles now done away with. Now turned into rubbing or rolling shoulders and hear bibbing. In Lusaka, all chiefs said, each chief was asked, all have done away with it. Not using the same razor blade. New needles are being used (fn. c2).

Sexual cleansing had been replaced by a new cleansing ritual without including sex. Instead of abolishing the cleansing rite as such, in Chief Bemba’s kingdom they had turned the cleansing process into rituals like; proxy- kuhuta, (women to women) or herbal baths that also included rubbing or rolling shoulders and hear bibbing. The different kingdoms came up with their own localized solutions to replace the risky practices, but without abolishing the


cultural symbolic and spiritual belief of the rite itself, namely chasing the ghosts after a dead husband to release them from the evil spirits.

The chiefs contributed to cultural change by transforming the content of the initiation rites, by promoting HIV/AIDS education to be a part of it, as also recommended by Dr. Phiri (The Post, 2005), forbidding lobola 1, forbidding early marriages and ensuring re-entries of female school-going girls after pregnancies and promoting girls’ education and gender equality.

The chiefs also promoted monogamy, e.g. Chief Bemba (f.n. c3, 2004) reiterated that Polygamy, a hot issue. This should die out slowly. New generations should concentrate on monogamy marriages. This was also raised at the Royal Foundations of Chiefs Meeting in a neighboring district last year, he continued, and added: Also issues of review polygamy and initiation ceremonies, he continued, (rather) train the old ladies to sensitize the young girls, to include this in the ceremonies. Culture and traditions do not change easily, but the chief’s view coincided with Gyekye’s (1997) theory of cultural transformation, the next generation have to assess and address existing traditions and practices and abolish those hindering development.

These examples show clearly the power of culture and spirituality in these Zambian societies. As Gausset (2004) claims, it is not a matter of abolishing the existing culture and traditions, what matters is that people change their behavior to avoid the spread of the disease. The interventions initiated by the chiefs followed the traditional procedures used by the chiefs, using their parliament, and their HM to search for new solutions to the challenges facing the development of their kingdom, until finally reaching consensus (Ngara, 2007, Taarn, 2004). After negotiations, a common declaration would been agreed, including the changes and new practices followed by new customary laws, and affiliated fines or punishments, as also indicated by Chief Bemba’s HM. The activities conducted by the traditional leaders to prevent the spread of the epidemic was an important part of the local capacity building.

The traditional leaders gradually developed a level of expertise and created new spaces for the dissemination of information related to the HIV/AIDS pandemic. The chiefs sensitized the communities by including HIV/AIDS messages in their local traditional ceremonies, gatherings and games, and informed about good and bad traditional beliefs and practices. The creation of these spaces for HIV/AIDS sensitization illustrates how the chiefs created spaces for explicit and implicit learning environments for the dissemination of preventive action in the kingdoms.

Since their activities coincided and concurred with the implementation of HIV/AIDS prevention in their local schools, this approach supported and strengthened the implementation of the HIV/ADS prevention education. The parents and the villagers were informed and sensitized through their traditional leaders according to the knowledge being taught to their children. A common value and interest shared between the school and their home environment 1 Women being enslaved for lifetime (Chief Bemba, c3, 2004)


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further reinforced the pupil’s learning outcome (Darnell and Hoem, 1996). This aspect was essential also for this program.

National, external advocacy

The traditional leaders did not only target their villagers but their commitment to the task made them use their expertise and speak out on the issue of HIV/AIDS in other fora where possible. Three of the chiefs heavily involved in the project were all influential Chiefs in their zones as illustrated in Figure 9.1, the structure of chiefs developed by GTZ (2004). They were representing their zones in the House of Chiefs in Lusaka, and used their voice and position and contributed to extend and enhance the approach by involving other chiefs through their participation in zonal and inter-zonal meetings in which they exchanged ideas and experiences.

Some of them took their HIV/AIDS interventions to the next level, e.g. Chief Musonda. In a meeting (c1, 2003,) he spoke about how he got an approval of the Chiefs’ Board at province level to tell the Royal Foundation of Chiefs in Lusaka about the HIV/AIDS approach being implemented in this province, as a means to address the way forward at the national level. In, 2003, as a member of the House of Chiefs he informed every participant about their role in sensitizing the people in his kingdom. The discussion of the approach resulted in passing a bill requiring Honorable Chiefs to be involved in HIV/AIDS prevention.

This intervention was also explained by Chief Zimba (c2), stating proudly; The Royal Foundation of chiefs, i.e. Board of chiefs, met in Lusaka, 2003, and approved a bill that the Honorable Chiefs must be involved. The Chiefs’ board from the province told Lusaka about (our province) and addressed the way forward. (f.n. Chief Zimba, c2, 2004). At Chief Bembas’s palace, 2005(c3), the same stody was told, adding with a laugther, At that time there was difficulties (laughter). The elderly made it difficult. It was not easy, because our tradition says sex should not be talked about (f.n. 2005).

The fact that three of the influential chiefs, themselves or through their HM actually pointed at their intervention through The House of Chiefs in Lusaka, shows the importance of the HIV/AIDS intervention initiated and conducted by Chief Musonda, supported by his two other provincial delegates to Lusaka. It also illustrates their commitment and ownership, as expressed by the chiefs in different occasions that they were involved in the project from the very beginning. It also shows their active role in the project as opposed to simply being consulted, or worse being manipulated, the lowest level of participation according to Arnstein’s (1963) participatory ladder.

Chief Musonda (c1) had at one occasion (2004) also been interviewed by the national TV, and forwarded the messages about activities, initiatives, impacts and the importance of involving the Chiefs in fighting HIV/AIDS. This was appreciated by the parents in his village, and the PTA representative (fn.c1) at


the local village school said; he always preaches HIV/AIDS in the media. The Chief is advocating, sensitizing all the people, even on television, (he) has been a key figure in advertising against the pandemic. Their faith in the chief, and the way they expressed their positive attitude to his involvement, confirmed the importance of the chiefs’ role in fighting HIV/AIDS.

The fact that he was approached for a TV interview, was also endorsed and commented on in the national newspapers, and was also posted on the web. The activities were not explicitly designed to reach out through the media, but the media also created the opportunities for a wider dissemination of the HIV/AIDS sensitization and prevention strategy, implicitly creating new spaces for HIV/AIDS discussions and reflection about the epidemic.

This also illustrates the kind of snow-ball effect that new interventions or object of activities may create, or what Engeström (2008) would call “knot-working”, where new strategies, ideas and innovations might be spread and applied to other contexts through informal interaction or information.

Transformation of customary laws and practices

The issue of gender inequality raised earlier, was not just related to subordination, from a patriarchal perspective. It was illustrating the contradiction between Zambian legal laws and the customary practices, as raised by Women Watch (2003) where the customary laws practically overruled the legal laws in many chiefdoms. This issue was raised by Chief Banda (fn.c4, 2006), when he informed us about the changes he had initiated in his kingdom; (Now) issues of property grabbing...when father dies, we (men) inherit women, and also property and children. But he continued: This is now a separated issue… have accepted as a Chief that these old practices will have to be abolished.

He thereby contributed to change, allowing the women to inherit the property of her previous husband if being widowed. She would then also be able to cater for their children and support the extended household where they belonged. Alternatively, these women would have to raise their own income, most probably, as have been discussed in Chapter Three, being forced into prostitution, and, as the driver told us (fn. 2004), send their girl-child to town to work by moving up and down.

Minutes from a training workshop (2006, c4) revealed that more risk was with girls due to being forced to marry early and getting pregnant while still young. The chiefs involved seemed to agree that early pregnancies should be abolished. Chief Bemba (c4) did not allow any girl under 16 to marry in his kingdom, according to his HM (2006, c4), a former principal as highlighted in an introductory meeting at the DEO’s office; A 13 year old should marry, and the Chief took it up seriously, talked to her parents. As the girl grew up, the girl was according to our tradition moved to another hut outside the main house. Now (after this incident) the girls’ houses should be built close to


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the main house! The location of the straw cottages1 established outside the cottage of her parents and other siblings enhanced the possibilities of unwanted pregnancies and early marriages. The fact that the Chief now intervened and required to build these houses closer to the main house, would reduce the incidents of sexual violation of young female adolescents.

The participatory bottom up approach ensured that the interventions reflected the needs and circumstances in the communities at large. As was revealed during the baseline surveys, also confirmed in relation to other localized intervention introduces by the chiefs, to fight the epidemic with relevant means required a localized approach.

The global NAC (UNAIDS, 2002, 2005) approach, seemingly too complex for the Zambian MOE to benefit from, represented a fixed top-down framework. Culturally appropriate mitigation strategies require interaction and participation from the local communities. By engaging with the local culture (Aggleton, 2006, Findings, 2005, UNESCO, 2005) linking the planning closely to the local traditions and values based upon residence, kinship and religion (Daun and Mundy, 2011) strengthened the quality of development programming.

The participatory development restored the power of local people to take the initiative and decisions of formulating and implementing activities by recognizing that the people are creators and partners who are responsible for their own development (Freire, 1996). Even though the project were located in districts within the same province, and they were sharing some common features and cultural practices, there were still local variations, reflected by the regional and local differences, it being a seasonal fishing area, a border town or harbor, or any other localized practices evolving over the years, as reflected in the baseline study. A situated approach (Leve and Wenger) ensured relevance (Serpell, 1998) and was in accordance with the MOE HIV/AIDS education guidelines (2002, 2003).

Chiefs’ school-based interventions

The traditional leaders did not only engage themselves by targeting the villagers in an informal setting, but were also involved by interacting directly with the schools, as an explicit capacity building activity, using their legitimate power. Chief Bemba (2005, fn.c3) told the following story, we have realized that pupils are now exited, want to learn, provoke thinking. I/NGO look into this as well. The Chiefdom has a subcommittee on statistics, the village HM work directly with schools, and how they are effected of HIV/AIDS, the secretary of sub-committees are mostly teachers (Chief Bemba’s Palace).

Many of the HM/W had previously been, or were actually principals or teachers. Their dual position in the society also helped to create the strong links 1 Cottages where the young girls/unmarried adolescents lived (PEO, f.n. 2005).


between the schools, the community and the traditional structure and shared worldviews. The chief’s observation of the impact of the interactive methodology applied in the ISACA intervention, the fact that the pupils were exited and wanted to learn about HIV/AIDS contrasts the boredom reflected in the 5-minutes approach applied as a result of the MOE circular.

The Chief (fn.c3) further illustrated this referring to another school visit he attended; I was also observing classes. Teachers seem to like teaching HIV/AIDS (through interactive methods). Pupils even open up! Both the teachers and the chief was surprised to hear what pupils say. It influences the community, he continued, they now gain knowledge from the children. Parents are informed and sensitized as is the Parent Teachers Association (PTA). They now come to meet me, telling about the knowledge of their children. The PTA executive is very interested (ibid.). As was argued by the children (2002), they wanted to teach their parents on technical or scientific knowledges regards HIV/AIDS, an argument that actually happened in real life situation. The children managed to break the traditional communication barrier. The parents again shared with their HM/W and chief and the link between the school, the parents and the community was strengthened, an informal and implicit dialogue, creating synergy that improved the knowledge sharing and creating a conducive learning environment among the school, the community and their parents (Darnell and Hoem, 1996).

The traditional leaders did not just go to visit schools, but developed different types of relationships with schools through PTAs. Chief Zimba reported (2004, fn. c2): If there are problems being reported we discuss, solve them, if at school level, or here, we do it at the council meeting. They directly contributed by using their parliament and legitimate power to resolve concerns and problems arising at school, also related to unwanted behavior among the pupils as well as teachers and within the villagers’ home. Quite often these cases were related to violation of the girl-child, or female students being impregnated by teachers, as being reported by Chief Zimba’s HM. Their fight against early pregnancies and gender violence, explained previously, also contributed to a harsher penalty for abuse, compared to previous practices where the teacher just negotiated with the parents and agreed on a small monetary penalty (HM f.n. c2, Chief Zimba’s council meeting).

Unintended innovations and transformations

As Engeström (1987, 2008) argues, interaction and sharing across traditional borders involving professionals as well as novices (Edwards, 2010) from different activity systems to engage in horizontal sharing towards a common objective creates new ideas leading to innovative actions. The solutions or innovations are not prescribed, and new interventions may lead to other unintended expansive learning cycles as exemplified below.


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One of the major interventions was the close collaboration between MOE at district and local level and the traditional leaders. One of the outcomes was a formalized collaboration between MOE and the traditional leaders during the project period, from 2002 to 2006. Chief Zimba expressed the new approach by saying (2004, f.n. c2): From that workshop (2002) we were all involved, working with the Ministry of Education. Formalizing the link between the Chiefs and the MOE sector, in a common effort of fighting the epidemic, certainly seemed to have made a significant change. This is consistent with another discussion with Chief Banda in his Palace in 2004(c2):

When a donor will address their activities they go to the Chief. The activities will have to fit the objectives of the local development trust. Now, a formalized link with MOE, legal body, and decentralized, support is to be decided by the Chief. Beautiful! Lovely! Before the chiefs were outside. Inclusion of the PTA/community into the MOE body, including the Chiefs, in (…) two years ago! Then the involvement of the chiefs was approved. The chiefs have the paper (fn.c2 2004).

By being formally involved in the HIV/AIDS prevention strategy, the chiefs also attended the introductory and planning meetings when the program was applied to new districts. During these meetings, civic leaders, NGO representatives etc. were involved as has been addressed in Chapter Eight. This was also the case when introducing ISACA to cohort 3 (2005). In that meeting Chief Bemba also addressed the importance of formalizing the chiefs’ inclusion in the Village Development Committees (VDCs). He argued that; as now, not having a formal representation at that level, it reduces the role of and the impact of localized public development interventions (fn.c3). This gap was also revealed by GTZ (2004), (see Figure 9.1), where this was raised as a critical issue for local development in the decentralized approach being implemented in Zambia. The Chief further argued that the Members of Parliament (MP) now appointed to these positions did not have legitimacy among the villagers, the people at the ground unless the chiefs would be allowed to join in. He asked the stakeholders during the joint planning meeting for the districts in cohort 2 if he as the Chief could be a member of the VDC in his kingdom, and if such a representation could be piloted in that district. The meeting recommended that and an application was later on submitted to the district authorities. This proposal was agreed and a pilot project where chiefs had a seat in the VDCs was established.

About 8 years later (2012), according to information from a recently employed DEBS in one of the actual districts, that structure was now formalized by law. Now the chiefs are a permanent member in the VDCs in Zambia. The gap identified by GTZ (2004) as a serious challenge in the Zambian decentralizing strategies had now found its solution. Based upon the findings revealed in this study, this also seemed to be crucial in a context where the


traditional leaders still had such a strong position in the Zambian society. They were, and still seem to have, their legitimate power holders, the custodians of traditions and culture, and also responsible for the land within their kingdoms according to the Zambian act, ruling out the responsibilities of the traditional leaders through the House of Chiefs in Zambia.

In the same planning meeting (c2) one of the NGO representatives presented findings that the District had approximately 50 out-of-school children; an issue that the DEBS seemed not to be aware of. This concern was discussed during the workshop, and a CBO representative working in the neighboring district promised to take action in order to give these children some basic schooling through the establishment of a community school.

At another introductory workshop, (minutes, c3) the possibilities of re-entry schemes for the young girls being married and/or pregnant was discussed. The messages from the Chief and his HM were clear. Under aged school girls if married should be reported on and re-entries for this group should be put in place. These practices were also equally shared with the other project districts. The re-entry right was also a part of the MOE’s strategies, although not being implemented throughout.

A school visit (2004, c3) also revealed innovative approaches to include the community. They collaborated with the Catholic Church in the neighborhood, and allowed the Church to use the school facilities to run literacy classes for the parents. The Sister, the Principal informed us, gave us some footballs to show her appreciation. We will also support them professionally by engaging in the teaching of the parents (fn. c3). New and innovative ways of horizontal collaboration between otherwise separated activity systems emerged through the application of a collaborative approach, even beyond the scope of this intervention.

A DEO (2004, c2) also focused on the impact of the chiefs involvement when, for example, their local chief had identified a risky area for 15-16 year olds where smoking and drinking (musongo) was taking place. He had parents and other villagers monitor the risky areas and advise young people to avoid these behaviors, including these gatherings.

The structural changes at DVC level i.e., incorporating the chiefs formally in the governing structure, innovative interventions developed between district authorities and collaboration with NGOs, local interventions between the school and Church, and other local interventions opened up for a variation of new activities, responding directly to the needs of the different participating actors. The new object of activity can be characterized as an iterative process of information sharing, participatory and bottom up interventions that reflected the local fingerprints in the given context.

Information sharing across the horizontal borders initiated interaction and enlightened the participants about policies, strategies and rights. These informal channels developed within the course of the project, certainly also enabled the districts and stakeholder involved to be aware of the existing policies, a knowledge that also helped the individual employees and districts to get their


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eligible financial resources. The interventions were a direct outcome based upon the approach agreed during the first introductory workshop, 2002, and expressed by the Major; “Ubuntu, we will win!” Facilitating collaboration and interaction across borders, going beyond the traditional vertical hierarchies, (Engeström, 2001, 2008) based upon professions, sectors, gender or status created, created learning leading to expansion of individual perceptions and knowledges resulting in unintended and new objects of activities.

Resistance

These interventions did not happen without resistance. The resistance was identified as resistance at individual level, actors that disapproved the approach for different reasons, not focused in this research. One HM wrote (c1) when identifying challenges and hindrances for succeeding according to the intervention’s overall objective that the more he was involved in HIV/AIDS Prevention the more he was afraid of losing his traditions. As was explained by the HM of Chief Zimba’s parliament (c2) it was difficult to get the elderly people to accept the changes.

Another way of coping with the changes proposed in the ISACA approach was expressed by a previous principal, now HM, during field visits to a DEO meeting (2004, fn.c2); Old traditions and practices e.g. polygamy is difficult to change, but one old retired principal, after his eights marriage said he could as well start advocating against polygamy.

The chiefs were present during the introductory and planning meetings, as confirmed in the minutes. The minutes were taken by the secretary being present during the provincial and district application and monitoring meetings also when these core project activities were conducted with the absence of the researcher. To what extent the chiefs and HM contributed and to what extent they all actively involved themselves is difficult to document. Some had frequent school visits, others said they visited their local schools once or twice a year, and rather sent their HM to replace them. However, the several visits to DEO’s offices and schools, the informal conversations confirmed the active involvement of actors within the chief’s structure.

One community from a district (c2) suffered from the absence of a local leader. There had been a 2-3 year dispute about whom would inherit the previous Chief’s position. The kingdom did not reach consensus, and it directly impacted the school negatively, according to a senior teacher we met during a field visit. They experience the absence of PTA, buildings needed repair, windows were broken, and desks and chairs were destroyed and the school suffered from lack of teaching materials. Teacher absenteeism was high. Parents, those few coming to school, brought with them sticks used to fight against each other when conflicts arose. The senior teacher we talked to blamed it on the lack of a chief in the area.


When the district education bord secretary (DEBS) in the same district was confronted with our experiences, he accused the chief and headmen in the district for being greedy. He alos blamed the PEO, complaining that it all was due to lack of information and support from the PEO’s level. In this districts the DEO did not monitor the schools according to the PEO’s guidelines, and many schools felt neglected by the district level.

A second visit was conducted the year after. The situation at the local school was about the same. No chief had been agreed upon and the primary school had not received support from the DEO level. The school needed maintenance, teaching materials and a sound managerial approach that linked the school and the parents. The DEBS had not followed up the instructions from PEO’s office as a result the DEBS were eventually fired as a consequence of this, one year after their involvement in the HIV/AIDS prevention approach, in 2004. This example also shows the important role of the individual actor. Resistance and neglect at different levels immediately is a risk factor in any program implementation.

The next subchapter will focus on the school-based interventions, focusing on the impacts of the work within the School-Community activity system, from province, district and school level.

9.2 Applying and implementing MOE’s HIV/AIDS education policies and strategies

One of the main recommendations from the workshop (2002) launching the HIV/AIDS approach was to ensure that MOE’s HIV/AIDS policies and strategies were implemented. Given a context where there generally was limited knowledge among educators, including principals and teachers, about HIV/AIDS policies and strategies, sensitization, and capacity building was the first priority. The various interventions had a twofold aspect, a joint learning process, while simultaneously creating solutions, through discursive and practical agentive actions (see Chapter Seven). Outcomes from the different interventions within the School Community, at province, district, school-, and community level will illustrate how the project activities emerged, how they were received and applied, at the various levels and among different stakeholders.

MOE HIV/AIDS education prevention interventions

The policy on HIV/AIDS prevention (MOE, 2002) and its guiding teacher manual (MOE, 2003) were the basis for the interventions scrutinized in the study. The manual recommended lessons with a duration from 30 to 45 minutes. As 10 percent of the curriculum could be decided upon locally according to MOE (2002) the approved recommendations from the planning meeting (c1) was to replace the 5-minutes approach, with one timetabled lesson a week.


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During the monitoring and evaluation annual meeting, (2006), chief Banda attended as an observer, as his chiefdom would be involved situated in one of the districts within the last project cohort in the province. He (fn.c4) summarized his concerns and the conclusions to how to further go about it, while also confirming his commitment to apply the approach in his chiefdom saying: A bit worried when listening to the debate related to 5 minute (HIV/AIDS) lesson being taught. HIV/AIDS education through MOE is not being taken seriously... it does not seem to worry the ministry…. It should not be for the PTA or head at each school to decide on this issue..... In no districts there are any changes! After the recommendation of keeping one timetabled lesson: You have resolved my problem!

It was agreed that the overall strategy should be coordinated by MOE at the PEO level. Based on a common framework, the activities were executed by the coordination team members and their affiliates responsible for the overall district interventions. The coordination team applied participatory and interactive methodologies where possible. The coordination team knew that they were acting as role models not only provided participants with interactive experiences but also led the participants in reflection on the approaches. For the participants these methodologies were new as they were more familiar with top-down traditional way of telling or giving orders through circulars on how to implement MOE programs.

The two HIV/AIDS experts at MOE HQ actually took part in one of the 5-days district-based training sessions conducted by the team (2005, c3), to learn more about the intervention. The HQ HIV/AIDS unit members showed their support, and carried this over to HIV/AIDS meetings conducted among senior MOE employees throughout the country. At a national workshop in Lusaka, 2005, our province coordinator proudly announced that, Southern Province had the best approach! (fn.c3). At least his comment reflected his own enthusiasm and belief in the HIV/AIDS prevention approach he was in charge of.

The researcher was observing a capacity building workshop (c3) conductd by two coordination team members. They started with inviting the oldest people to raise their hands asked them to come forward to the facilitators, 18 out of approximately 60 participants were selected to come up in front. They wrote their age on a piece of paper, pairs were formed, the youngest had to sit down, and at the end, one person, the oldest one, was left in front of the gathering. The facilitator then respectfully greeted the oldest one, introduced the theme to be discussed and taught, and while acknowledging the topic actually was culturally inappropriate to discuss in the open, he asked for the approval of the eldest participant, who agreed.

This small intervention highlights the importance of using and adhering to the local protocols. Knowing the senior position of the elderly in the society, respecting and approving their role through this exercise was given credibility in the sense that it was conducted by a Zambian senior MOE employee. The recognition of local culture and protocol is in line with Smith’s (1999) theory of


decolonizing methodology. As Inglehardt (2005) has revealed, a foreigner will not be assigned the same trust as a person being “one of them”, a sister or a brother. They all were asked to go beyond traditions and taboos, and yet use cultural tools and means situated in and conducive to the local context to achieve openness and dialogue.

The different HIV/AIDS interventions vary based on input from the participants. The outcomes related to concrete district and school applications and localized HIV/AIDS education prevention activities also reflected variety. The iterative approach resulted in a multifold and diverse type of interventions, based upon the views of the actors involved, and the social space in where they were generating the new object of activity, their HIV/AIDS prevention strategy.

District interventions

Chapter Nine illustrated how the multivoiced planning sessions, the basis for the district application processes, finally resulted in a concrete district wide plan of action. The following excerpt is from the minutes from one of the application work-shops introducing and applying the intervention to cohort three (c3), in 2005, “The stakeholders including three District Education Board Secretaries (DEBS) and other DEO representatives attended a HIV/AIDS meeting where the overview of HIV/AIDS education in the districts was discussed. During this meeting, gaps were identified and a program of action for the seemed gaps was drawn for the year 2005” (Minutes, secretary).

After the application of ISACA to one of the districts in cohort three, a principal explained: To some extent I feel we are really behind in terms of information and knowledge. We have really acquired a lot of issues amongst many more people. Interactive methodologies – this is really needed in our day to day professional teaching. Voices from the young people – also we have learnt that children are not a “tabula raza” hence we need to acquire and know their culture so that we can devise methods to systematically guide and advise them (fn.c3). The interactive methodology applied in the teachers’ guides (MOE, 2003), further described in chapter Five seemed to be an eye-opener not just as it related to HIV/AIDS education, but as an approaching their day to day professional teaching. To acknowledge that the children’s voices and interaction were an important asset in the learning process itself, contributing to a more differentiated approach to meet the needs of the individual child, was an eye opener, not only for the principals, but was also revealed as an important learning outcome in their professional lives as teachers.

Based on the district’s action plans, each district was responsible for organizing a 5-day in-service training of selected staff members targeting each basic school in the entire district. The training was conducted by the core project team supported by the college lecturers and had to be coordinated accordingly. Some principals experienced difficulties with some communities which did not agree to the teaching of HIV/AIDS as they believed that education on HIV


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prevention was counter to their traditions. Some communities that were polygamous were resistant as they thought they would be compelled to outlaw the practice. There were also those communities that did not want to protect or even talk about caring of the sick. The open discussion of sexual organs was difficult in nearly every community. As one community member (fn.c3) put it: Traditionally not acceptable to talk about private parts., He continued, we call a spade a spade - talk to the principals - lectures draw the organs, using local language - some look aside, close their eyes, some see. We have that problem the only way is to understand how to deal with it.

As noted by the DEBS, there were various responses from villagers when being exposed to the HIV/AIDS education strategy. The communities guided by their cultural norms and traditions rejected the new knowledge, and many did not want to take up the recommendations conveyed through districts and school-based interventions. Their dual bound; e.g. the contradiction between the scientific knowledge, the western tools and artifacts, requiring openness and dialogue opposed to their customs of silencing, created a dilemma, and it was difficult for quite some villagers to open up, more difficult for the elderly.

At a field visit to a semi-urban, central district, in cohort two, it was told that the district had 124 basic and 42 community schools. They were in the process of training the three staff members from each school, and as underscored by the DEBS, she was impressed by how the teachers after the training were opening up gradually. Now coming up for VCT never the case before, she continued. This coincides and confirms experiences from what happened in most districts. When opening up and being able to discuss HIV/AIDS within the school environment, the teachers themselves were empowered to actually check their HIV/AIDS status, and thereby also access Antiretroviral drugs (ARV’s).

In this district (c2), as in most of the districts involved in the program, formed their teacher support groups, which enabled the teachers to go to work, in spite of carrying their fear or even secret of being infected. As one principal said (c1), some teachers gradually isolate themselves and do not interact with their colleagues that is the first sign! The fear of being infected and the consequences, not just health wise, but also related to stigmatization, not just for the individual, but also for their family and children made the psychological pressure difficult to carry. The first reaction was then trying to hide it. The support to teachers living with HIV/AIDS was one step towards opening up, and an avenue for the teachers to share experiences, feel secure when opening up, and empower them in their devastating situation.

The huge number of schools, more than 126 public schools, and the size of this district made it difficult for the DEO to organize the activities according to the overall ISACA strategy. The DEBS (c2) confirmed that: (This district) is difficult to monitor, motorbikes would be the best, most of the schools have not yet been reached, 10 visited so far. Zonal training are now timetabled and the school-based interventions are being done differently (fn.c2). She understood the need for the diverse approach to


HIV/AIDS education prevention as a responding to the local context and the decentralized, participatory and iterative approach.

One principal put it like this (fn.c2): The province education officer show interest in this - in passing it to teachers - schools - communities. The coordination committee, once in a while, go around to districts and principals. Lots of support from the province, supervision and teacher guides and materials on interactive methodology, funding through the sector pool and some from the budget targeting special issues. The Provincial level followed up and supported the schools which shows accountability and created trust. It was obvious that those elements in the program also created commitment and support among the MOE staff at various levels. Zambians were in the lead, and were initiating, executing and following up most of the program activities.

Each school followed up through a so-called cascade training approach where the trained team of three from each school, including the principal, had to commit themselves to follow up with a school-based training focusing on HIV/AIDS education (MOE, 2002, 2003) applying the principles to their local context. The different school-based interventions also comprised activities targeting the community at large. As one principal expressed it (c2); Foresee difficulties: Attitudes by parents; do think it do not exists, witchcraft, they need more sensitization. Major problem: illiterate parents!

School-based application

The last session during the training and district application workshop, each district and school had to sit together and plan a strategy for the school-based interventions. Each school had to find their own solutions to the school and community-based interventions, e.g. the in-service teacher training, the information to the students and community at large.

The principal in a district, (2005, fn.c3) told us the following story; On Friday we oriented the pupils, grade 1-4 in brief, they will later be taught in class, from 10:00-13:30 we had a session with grade 7-9. They got details on private parts, also in the local language, they were open. During the first presentation, they were shying away talking about it. The male mentioned the female parts. The female mention the male parts. HIV/AIDS education is now timetabled once a week. It will work out, full appreciation after the introduction. The teachers will manage, they are happy about it. The principals had used smiling faces to assess the teachers’ views. Out of 19 teachers, only one had a negative or grumpy face and no one circled the middle one! Today, she continued; we have full participation among the pupils.

This school had organized two sessions, differentiated between the pupils by age group, and put more time and emphasis on grade 7-9. The use of local language was also applied in some sessions in the district training in order to make sure that the concepts were being used accurately and captured any locally adapted terms to filter for bias and discrimination. By so doing, the idea was to mitigate stigma and discrimination towards people living with HIV/AIDS. It


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opened up for interaction focusing on care and support, as recommended in the HIV/AIDS Manual (MOE, 2003), and endorsed by UNAIDS (2005, 2007) and as argued by UNESCO (2004).

The fact that the teachers anonymously fully supported the training by indicating it with the smiling faces, illustrates a transition from a “five minutes approach”, to a more advanced object of activity, e.g. applying an Interactive Methodology during their HIV/AIDS education. The pupil’s engagement and participation during the lessons also reflected a change in the pupils’ attitudes towards HIV/AIDS education, moving from boredom to dialogue and sharing.

The principal from a basic school informed the team on the procedures they had followed when applying the training (2004, fn.c2); After the training in interactive methodology, where principals, guidance and counselling teachers and grade 5 teachers were trained last week for 2 days, the same three carried on workshops for children at our school. Now anti-aids club patron teacher teach one grade every week. Community sensitization target PTA committee, HM, Churches and members of community. Information is submitted to DEBS, and we got one book for the staff on Interactive Methodology. Teachers are open: asked why is a mosquito not infected? Our Chief sent his people to the community to sensitize as well. Peer educators are trained, established HIV/AIDS corner with contributions from pupils grade 6-9. Foresee difficulties: Attitudes by parents; do think it (HIV/AIDS) do not exists, witchcraft, they need more sensitization. A major problem is illiterate parents.

This school had assigned 2 days for the in-service training, and thereafter given the Anti-Aids Club patron the responsibility for teaching the classes, whereas in other schools, a number of teachers were teaching HIV/AIDS to their own classes. With the establishment of an HIV/AIDS corner run by the older pupils, peer education was implemented in most of the schools in the province. Some had a physical corner in one classroom, whereas in other schools the peer educators had been assigned a separate room for that purpose. That made it easier for other pupils to talk freely when they had issues to discuss. The peer educators trained, and guided their mates in concepts of safe sex, gave advice on where to get medical care and treatment, in case of pregnancies.

The principal’s story reflects some of the challenges the schools were facing. It was not just the teachers’ questions that posed challenges but the parents’ misconceptions, denial and beliefs in witchcraft were among the other hurtles faced at the school level. A high rate of illiteracy among parents likely contributed to these challenges. The Chief’s contribution is highlighted and indicates what has been discussed previously, how important their participation was viewed and endorsed by the school leaders.

The local conditions and priorities at the individual school resulted in different practices and local solutions to how they actually conducted the training, related to the community-members and parents, as well as how they actually organized the work of the peer educators. In some instances, the peer educators got a separate room in the school. This enabled them to have meetings with students and peers anonymously. Where the facilities did not allow for that,


a classroom could be used according to agreed schedules or a HIV/AIDS corner was utilized for consultations.

Another school visit revealed the following, (principal, fn.c 3): Previously we had sensitization on HIV/AIDS daily, the 5 minutes approach. After last December in-service training, a part of the subject is now timetabled. Now teachers are talking in local language, bringing in the danger of HIV/AIDS. The local language was supposed to be the language of instruction from grade 1-4, (see Chapter Three). In the case of HIV/AIDS education, there were a lot of terms that did not have their equivalent local translation. In other instances, the local language or some of the terms also indicated a gender biased and discriminatory attitude, related to sex and stigmatization of people infected. The in-service training included awareness raising and issues addressing this specifically, and as underscored by this principal, most teachers apply it in their teaching.

In some schools, the HIV/AIDS education was conducted in gender- segregated groups, in other schools they were divided by age. Whatever solution, it had its advantages and disadvantages, as explained by the principal during a school in cohort three. The principal (fn.c3) told us that, Pupils got info by grade, in mixed groups. The girls seemed to be a bit shy, boys feel freer, due to traditions. Women have little to say. They are not free. After the sensitization it is much easier. I observed a lesson. Children were happy, 3/4th participated, very well. By the end they all then realised it was HIV/AIDS education. She continued; Grade 6 teacher said: This is an eye-opener! Even teachers are open to talk about it! We left out certain info - realizes after the training, in working with the elders – we work together. Despite this ... the disease, some still believe in witchcraft, specifically those afraid of hearing about the disease.

The traditional subordination of the women and the girl child underscored how the gender differences restricted the girls from participating on equal footing with their male classmates. Applying an interactive approach seemed to help the female students, as well as the teachers to gradually open up. Some teachers also underscored the value of actually also learn from their pupils, something that rarely happened through the traditional modes of teaching.

In order to include and get the elderly involved in the sensitization in their community, this school had decided to leave out some information. The power of traditions, norms and spiritual beliefs, the symbolic power of culture overruled the scientific and rational knowledge about sexuality and dissemination modes. This was also confirmed by another principal (fn.c3) complaining that; Due to the breakdown of communication the chief could not come. We usually have a good relationship with the Chief. Parents were invited for this, but complained because they did not want to discuss this matter among the young ones, that they are experimenting. We have a plan with our guidance teacher to sensitize the villagers, also in-school visits, we can learn from other schools in interactive methodology, using books on life skills, see how topics can be integrated in the classroom. The parents did not talk about sex with their children, one reason is the cultural aspect, but people also generally argued and believed that discussing and addressing HIV/AIDS with the young ones would enhance their sexual engagement.


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At a Zonal school (2005, fn.c3), the principal, also living with HIV/AIDS herself told us about the district training procedures and continued; Then 1 day school-based training in Interactive Methodology, all got together, included selected PTAs, interested. Sessions were conducted at school level. PTA gave money to run the workshop. All 3 from our school were trained to speak and teach. The first time they (all teachers) experienced a workshop within the school itself. Usually just one or two go out for training!

She pointed at an issue being addressed by others during the course of the project, the importance of getting everybody onboard, for everybody to be able to take part in school-based interventions and agree on school-policies on HIV/AIDS rooted in a common understanding and visioning. She also highlighted the school-based cascade training approach to in-service training. Usually just one or two teachers went for training. In this case, all teachers took part in the training, the first time they were running a workshop within the school itself, an innovation that could be applied as a future in-service activities.

Parental support and school-community collaboration was clearly demonstrated by the fact that the PTA supported the school by giving money to the workshop. It also indicated the importance and relevance of the topic in this specific context, and a strong support from the community. This close collaboration and support between the traditional and school community opened up for a learning process, characterized as a strengthened socialization process according to Darnell and Hoem (1996), creating the best learning conditions for the pupil.

At a school fairly recently included in the project (2003, c2) the principal explained that they had done the in-house training on Interactive methodology. The DEBS was informed, and HIV/AIDS education was now timetabled on their lesson plans, and the principal continued: The one book we have is rotating, with just one book it is difficult to prepare and have the right material. When we started the training the teachers said it was taboo, now they speak freely about it. After having done the training, he was now just waiting for the teacher guides (MOE, 2003) to arrive, he continued. When the coordination team were there for a field visit the principal specifically underscored the fact that the DEBS were informed. These guides would be submitted to the schools after the school-based intervention.

He continued (fn.c2): It felt good, new approach, facts and methods, even talking compounds, happy about that! Provokes and open up for talk! The talking compounds, usually being referred to as talking trees and in some cases even talking stones, were hand-made signs posted in trees or at any convenient and available spot within the school campus. Some DEO offices also had similar signs outside their offices. The messages could be “ABC”, “Condomize”, “No stigmatization”, “Take care of PLWHE” etc. These messages, as the principal noted, provoked and opened up for talk and informal discussions, creating spaces for implicit learning processes.

Each of the cases referred to above, show the important role of the school leadership, when engaging in the implementation of HIV/AIDS education,


initiating implicit discourses and reflections about HIV/AIDS related issues. Where the principal took an active role and engaged him/herself the teachers, pupils and also the parents were more likely to participate and apply the new knowledge on HIV/AIDS prevention.

This coincided with the experiences from one basic school: We had one open day with the community. Implementation is going on by all teachers. Interactive methodology, usually every day in classes, timetabled, according to the principal (fn.c3). At a visit to one of the basic schools in the area, the principal told us that; finally the DEO is accountable to our school, following us up! (fn.c2). Regular visits from the DEO to monitor the project activities were positively received among the principals and teachers. Their efforts were recognized and opposed to the usual controlling aspects when the Districts Education Standards Officers came to visit the school, the supervisory role of the guidance and counselling officer were highly appreciated.

The MOE employees were also equally happy to see how this collaboration helped bridge the gap between the schools, the parents and the broader community. This is a precondition for the HIV/AIDS education to actually reach out to the pupils in school, according to the senior PEO HIV/AIDS advisor (2005, fn.c3). Representatives from HQ MOE also came to visit schools in the province to observe the outcome of the project, and actually endorsed the initiative taken at the province level.

From telling to interacting, boredom to eagerness

The circulars from MOE (2000), ordering the schools to convey messages about the danger of contracting HIV/AIDS the first 5 minutes every day, were applied to in most of the schools visited during the pre-project period, 2000-2002. Schools not being a part of the project also continued the same practice long after the new HIV/AIDS education policy from MOE (2002). The messages that basically were conveyed reflected what has been referred to as selective teaching, at the best, and as a PTA member said (fn.c1); every morning the principal gather the pupils to give them strong messages on HIV/AIDS like, HIV/AIDS is a killer, HIV/AIDS has no cure, Abstinence etc. The impact of these teaching approaches were as stated in monitoring meetings as late as in 2006, by one principal (fn.c2) We actually know that children are waiting 5 minutes outside the classroom to escape from the first 5 minutes. This was followed up by another principal (fn.c3) It happens in our schools as well, need to revitalize the HIV/AIDS education approach. These 5-minutes inputs, rarely had any impact on the children’s attitudes or behavior, as they did not address the underlying foundations of indigenous culture and the artifacts mediating and controlling the lives in the communities (Breidlid, 2013, Gyekye, 1997). The repetitiveness rather turned the messages into boredom and the pupils demonstrated this by not entering the classroom until the message was delivered. The “messages” were isolated events, not integrated parts of a comprehensive


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HIV/AIDS prevention strategy, e.g. MOE (2003), where the topic were situated in the contextual realities of the children.

A college tutor and HIV/AIDS trainer summarized his views in the following statement; Authoritative approaches where knowledge is with one person who palls it into others, will not affect people's behavior much. Besides, boredom makes learning uninteresting. The best approach is therefore interactive methodologies. These are methods where the learners' participation is valued in the learning process. In other words, the learner is actually at the center of the solution to the problem (Lecturer, fn.c1, 2003). This learner centered and interactive approach was the strategy underlying the Interactive Methodology on HIV/AIDS (MOE, 2003), as revealed in Chapter Three.

The outcome of this change is further illustrated in the following excerpts from a visit to a basic school in chiefs Musonda’s kingdom, (2005, c3). The school were among the first schools to join the project, cohort one, (2003) so this visit was conducted after they had been running the project for some years. The principal told us that, Teachers are more confident with the books (Interactive methodology). Before it was boring, repetition, “Sex is a killer”, “ABC-approach” etc. People and teachers were bored. Now we have the books presenting different approaches and methodologies. HIV/AIDS is integrated in grade 9. It came out in the essay, the exam. They pupil had been searching on their own context (fn.c3). He further explained how they had conducted a school-based workshop on Interactive methodology, using charts, and continued: Each of the teachers were writing, they are eager. Teacher’s group meeting every Friday, each group of teachers is then preparing something and they are trying and explaining, learning from each other. This is initiated by me, (ibid.) the principal proudly announced.

The integration of HIV/AIDS as illustrated above goes beyond a classroom approach, as the pupils not only study the books, but go out and search information and local knowledge on issues addressing their own context, merge their local cultural and contextual reality with their theoretical knowledge. The school was also applying collaborative teaching and teamwork during their weekly gatherings, and shared ideas and innovation between each other, developing their own community of learning.

School/community implementation

Different relationships and collaboration between the school and the community have been explored in the previous sub-chapters, but examples on vertical interaction between the two activity systems is further illustrated below. A principal told us (fn.c2); I always talk about it (HIV/AIDS) with them (parents). In a workshop last week, a talk of HIV/AIDS meant to be 15 minutes turned into being 30. After the discussions, they (parents) bring experiences from their homes. A similar story was told by a principal (fn.c3), at a visit to a basic school; Last week we had training


of parents (PTAs) so that they are aware, also those involved in CHANGES1 were present, and churches were represented with two patrons. The reactions were not bad, health workers said, this is what they do in hospitals, they were happy to hear that the schools also are working. The pastors accepted to speak about the private parts in their meetings. We got their permission to teach the pupils on these issues. As can be seen, the principals usually did not spell out issues related to sexuality directly. They referred to private parts, reflecting the way most people avoid speaking up directly on issues relevant in the HIV/AIDS discourse.

The HIV/AIDS focal point person at basic level in a district (2005, fn.c3), endorsed the program, and told us about the impacts, after having run the timetabled HIV/AIDS lessons for about a year; specifically the issue of stigma, has improved. Lots of HIV positive around, but a friend is a friend. Teachers do not stigmatize. Encouraging each other, if they are frequently ill. Assisting parents, and orphans, even teachers supplement, specifically food. Pregnancies… had them before, two last year, but the girls are still coming to school, grade 8 and 9, will also come back after delivery. One girl in grade 8 recently got pregnant.

Some of the chiefs also visited schools and classroom level, illustrated by this story told us by chief Banda (2004): We have action groups, going out to the community. The senior Head Man (is) leader of the action group. One child turned HIV positive, now (he is) at school, before they hid the child from going to school. Parents said, I was shy, now they open up. This is after the guidance and counselling, they know “this is confidential (fn.c2). The story also illustrates the issue of stigma and taboo. Trust is under these circumstances crucial, knowing that neither the child nor the family will suffer from stigmatization.

Openness is transferable, a female principle told us (fn.c 3). She was living with HIV/AIDS herself, and had been open about it for a while. When her school was introduced to the program, 2004 (fn.c2), she started by inviting the 14 HM surrounding the school, and continued; I call all those when we do this, also telling why. Before this meeting, they did not feel it was needed. Bilharzia, malaria, also parts of the sicknesses. We talked about it, the worms come out. We need to create openness on different diseases. The chairperson of the HM, senior HM is forceful.

Resistance, individual and institutional hindrances

These interventions did not happen without resistance. Some resistance were caused by individuals that for different reasons disapproved the approach. One HM wrote (c1) when identifying challenges and hindrances for succeeding according to the intervention’s overall objective that the more he was involved in HIV/AIDS Prevention the more he was afraid of losing his traditions. As was explained by the HM of Chief Zimba’s parliament (c2) it was difficult to get the elderly people to accept the changes.

1 A USAID-funded education and health project.


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Another way of coping with the changes proposed in the ISACA approach was expressed by a previous principal, now HM, during field visits to a DEO meeting (2004, fn.c2); Old traditions and practices e.g. polygamy is difficult to change, but one old retired principal, after his eights marriage said he could as well start advocating against polygamy.

The chiefs were present during the introductory and planning meetings, as confirmed in the minutes. The minutes were taken by the secretary being present during the provincial and district application and monitoring meetings, also when these core project activities were conducted with the absence of the researcher. To what extent the chiefs and HM contributed and to what extent they all actively involved themselves is difficult to document. Some had frequent school visits, others said they visited their local schools once or twice a year, and rather sent their HM to replace them. However, the several visits to DEO’s offices and schools, the informal conversations confirmed the active involvement of actors within the chief’s structure.

One community from a district (c2) suffered from the absence of a local leader. There had been a 2-3 year dispute about whom would inherit the previous Chief’s position. The kingdom did not reach consensus, and it directly affected the school negatively, according to a senior teacher we met during a field visit. They experience the absence of PTA, buildings needed repair, windows were broken, and desks and chairs were destroyed and the school suffered from lack of teaching materials. Teacher absenteeism was high. Parents, those few coming to school, brought with them sticks used to fight against each other when conflicts arose. The senior teacher we talked to blamed it on the lack of a chief in the area.

When the district education bord secretary (DEBS), newly employed, in the same district was confronted with our experiences, he stated, Chiefs are a big problem, they want money for themselves and their own wives. He also blamed the PEO, complaining that it all was due to lack of information and support from the PEO’s level. In this districts the DEO did not monitor the schools according to the PEO’s guidelines, and many schools felt neglected by the district level. Not surprisingly, within his district there were quite a number of schools visited where the chiefs seemed to be absent or rarely involved in the activities at school level. The national project staff finally moved this person to another district where HIV/AIDS education had been timetabled and implemented jointly with the traditional leaders. Resistance and neglect at different levels immediately is a risk factor in any program implementation.

In another district (c3), the principle at basic level did not have detailed overview of the new HIV/AIDS approach, as the district level, in this case overlooked the participatory approach and run a small cascade approach to sensitize the principals instead. The principal had tried sensitizing the teachers in Interactive Methodology, the team was told, but the school had no policy for advocating HIV/AIDS prevention education in his school. There were no


engagement from the community. Five of his teachers had also been trained in KARA counselling, where also GTZ and CHANGES were involved, he continued. Due to the big new farmers in the area, the husbands were working the whole day away from home and it was therefore difficult to get them to the schools for meetings. The old chief structure did not work that well either, since the men had to work in the fields all day.

Some schools also faced a huge challenge related to resistance from the communities…because of the Interactive Methods we are using as regards to HIV/AIDS …some people feel it is more centered in cultural erosion, one principal explained (fn.c3). There is also traditional rigidity, polygamy and other cultural practices that are deeply entwined with their way of living such that it is difficult to eliminate, there is too much stigmatization and discrimination and therefore people would rather keep quiet than come out in the open, he continued.

In addition, other factors also influenced the implementation of the intervention negatively. One serious disturbance was the frequent structural changes at DEO level. During the inception, c1, the FFP was in charge of HIV/AIDS education prevention, the year after the DEBS got the responsibility, and about a year after, the human resource officer (HRO) were the one in charge for implementation and monitoring HIV/AIDS mitigation activities. As complained by the senior PEO coordinator (fn.c4), As now, the HRO seem to be busy with teachers transfer, employment etc., and do not have the confidentiality needed to deal with personal matters as HIV/AIDS and counselling. However, it was not only the transfer of staff that resulted in too heavy workloads, as well as a lack of continuation and capacity that caused problems for the implementation.

Other HIV/AIDS projects run through I/NGOs also caused confusion at school level. The coordination team visited a basic school from cohort 1 that successfully had implemented the Interactive Methodology, had timetabled it and run lessons on HIV/AIDS prevention for 16 months. The principal told us (fn.c3) that the school had to change its approach. A representative from an I/NGO’ had told them: Don’t timetable it (Interactive Methodology) until you get a circular from HQ! The PEO representative in the program coordination team the commented: This is beyond his legislation, it goes beyond his limits, this decition has to go through DEBS and PEOs office, even the Permanent Secretary should pass through PEOs office, now we have a decentralized approach that is our policy (fn.c3).

Information from a principle at another basic school (fn.c4, 2006) also had the same experiences. He told us that for one year they had HIV/AIDS education timetabled. If it is not on the timetable, then those who are shy will find reasons for not taking it up seriously in classes. The culture makes it difficult to teach, if it is here, (e.g. on the weekly timetable) they cannot leave it. This is a serious issue we have to tackle now, he stated (fn.c4). The principal had been advised by the international INGOs representative visiting the school 2-3 weeks ago to remove HIV/AIDS as a timetabled activity! They had argued it should be conducted as a cross-cutting issue. Now we do not teach it as a separate subject, we try integrating it in so many subjects, the principle added (fn.c4). This illustrates a quaternary contradiction,


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where external activities initiated outside the existing program works in parallel and with conflicting approaches

Dr. Piri, in The Post, also raised an important issue illustrating the power of international donors. There seem to be an information gap between the donors and the Zambian MOE, regards our actual policies on HIV/AIDS. They come here with their money, and implement their strategies without proper coordination. President Bush say , leave out the C (condomize), and focus on A, abstinence and B, be faithful, then you are eligible for funding In other words, all the projects funded through ZANARA have to change their policy, from A,B, C to a A,B approach.

As can be seen from the examples above, individual, contextual and cultural issues were in many instances difficult to go beyond during the years of the program interventions. Surprisingly, the role of the donors, their hegemonic way of imposing their project upon different actors, it being representatives within or outside the MOE sector , a global policy and strategy, an international funding actor or other external HIV/AIDS initiated project disturbed and created confusions, conflicts and challenges where they contradicted with the overall national strategy, a quaternary contradiction.

9.3 Summary In this chapter, the impacts of the chiefs’ direct involvement in preventing the spread of HIV/AIDS within their kingdoms has been illustrated with the excerpts from some of the most influential chiefs. Firstly, through their engagement in the planning process, secondly their interventions within their own kingdom and but also through their engagement through external social marketing (ibid) of the projects’ various components and strategies.

They directly contributed to openness and transformation by also being role models, while not abolishing culture and tradition (Aggleton, 2003, Gausset, 1997) or eroding or removing the cultural scripts, rites and schemas (Cole, 1998; Werscht, 1998). Instead they used their traditional structures and internal indigenous processes to transform the procedures and content of the rituals, e.g. from sexual cleansing to e.g. rubbing backs, or herb baths.

Through these procedures, the kingdoms reached to different local solutions. As far as they managed to turn sexual cleansing into a renewed and safe behavior abolishing practices being the drivers of the epidemic, the challenges of reducing new infections through these rites were reduced or eliminated (Gausset, 1997).

At district and school level, the various activities were also reflecting their own conditions and priorities as they at both levels, specifically at school level, found their own solutions within the overall iterative HIV/AIDS framework. This was based upon access to resources and own priorities, their physical facilities, collaborating partners, as INGO’s, CBO’s or faith-based, and also their


relationship and collaboration with the traditional leaders. Some individual actors also contributed to resistance hindering a smooth development and implementation of the new HIV/AIDS approach. Support where needed followed up with close continuous monitoring and evaluation of the HIV/AIDS interventions at school level, also created a closer relationship between the schools and the DEO in several instances.

At district level, a systemic training of MOE employees, including principals and senior teachers, were being conducted. MOE policies were shared and the trained team from each school conducted their own school-based workshops on Interactive Methodology of HIV/AIDS (MOE, 2003) within a scheduled timeframe. The 5-minutes approach was gradually replaced by a timetabled interactive HIV/AIDS prevention education, which in general was highly appreciated by teachers as well as the pupils. Using the local language contributed to reduce gender biased and discriminatory concepts, and the HIV/AIDS prevention education was conducted in both segregated and mixed classes. Peer education and community-based initiatives were developed locally, according to the conditions and needs at school level.

The fact that teachers, students and the community as a whole were able to open up about HIV/AIDS also helped infected teachers to get tested, access ARVs as the stigma gradually were reduced. The same tendencies were experienced among pupils, and the number of re-entry schemes for girls that have given birth were increased. As was the case within the traditional community, also the school community proved to find their own solution to their HIV/AIDS. In Chapter 10, some of the the findings will be highlighted while relating them directly to the contradictions, their characteristics, manifistations and solutions, and and how they can contribute to future development research and practices.

Chapter 10

Key Findings and Contributions

This chapter builds upon the findings, and offers new insights on the importance of the use of the research theories and practices in future development work. Where the population were either infected or impacted by the HIV/AIDS epidemic, living with the HIV/AIDS epidemic as a daily threat, were people actually “Caught in Culture?” while dealing with the reality of the disease and its consequences on their communities, schools and families? The study reveals that far from being caught or trapped in culture, partners in the HIV/AIDS prevention education program in the study are actually empowered to use their culture, and historical epistemological lens to find solutions to the pandemic.

The chapter frames the findings using Engeström’s theories while also exemplify types of contradictions, its characteristics and manifistations, and lastly their solutions. Bernstein’s concept of regulative and symbolic control also contributes to a broader understanding of the underlying processes and outcomes of the study. The chapter further explores how the lessons learned in the development/research approach may contribute to ethical and decolonized development discourses. The chapter ends with some reflections and thoughts on future development research.

10.1 Key findings The study explores and examines how behavioral change and transformation was initiated and developed from within. In a complex research context, where commitment to change worked hand in hang with resistance, critique, ambiguity, explicating new possibilities, envisioning new patterns or models of activity, CHAT and expansive learning was applied, giving a tool for deconstructing dialogue and negotiations to unveail the processes of change. The baseline surveys, the various contradictions between policies and the actual local implementation, the participatory approaches where local stakeholders identified issues and possible solutions and outcomes, illustrated factors leading towards a


diverse set of localized solutions to the problem. The processes at play and the final outputs of the interventions cut across the borders of formal and informal organizational and individual learning (here: implicit and explicit learning). Transformations and change, as illustrated in the study, further demands a lengthy process that can be supported by means of formative interventions. The third generation of CHAT (Engeström, 1987, 2001) has been used as a tool to deconstruct the data and identify the key contradictions within each domain of the two main interacting activity systems at play: the Traditional and the School/Community systems (see Chapter 7, Figures 7.1, 7.2 and 7.3). It further represents the overall framework used as a tool to analyze the findings, e.g. the existing HIV/AIDs prevention discourses, policies, strategies and experienced realities among core stakeholders leading to the various solutions.

Program inception: Local perceptions and experiences of HIV/AIDS education

In the initial stages of the program, a needs analysis and other baseline activities were carried out to identify the needs, resistance, dichotomies and dilemmas (the contradictions), manifested through the voices and activities of the multiplicity of stakeholders in different contexts across and within the two activity systems. This enabled the researcher to identify the matches and mismatches between local, national and global approaches and identify areas of congruence and dissimilarities. The findings from the baseline revealed mismatches between the local contexts, worldviews and needs, and the national application of the global HIV/AIDS strategies.

During the inception period, the baseline surveys revealed that school principals were unaware of MOE’s HIV/AIDS policies and school-based strategies. All members of society at the time were experiencing the epidemic and principals expressed a sense of urgency toward trying to mitigate the effects. From their perspective, schools should play a leading role in fighting the disease. However, they were unable to even express themselves in group presentations on the impacts of HIV/AIDS. Principals were caught in a double bound – between professional obligations as educators and their cultural obligations. Culture constrained open discussions on sex and sexuality as it related to HIV/AIDS.

The results from baseline surveys conducted before the new intervention took place revealed that stakeholders, from MOE officials at district to school level, were unaware of the existing policies and strategies on HIV/AIDS prevention education. They saw the importance of applying HIV/AIDS prevention as a part of the curriculum and syllabus, but did not know how to implement it. They lacked information, had not been consulted and did not have training opportunities on HIV/AIDS prevention education. In addition, the schools did not receive adequate teaching materials.


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Findings from meetings with principals, the various school visits and cluster meetings indicated that sociocultural and contextual conditions contributed to the factors described as drivers of the virus. Taboos were major barriers; it was inappropriate to speak freely about HIV/AIDS in the school or other public context. Any talk about HIV/AIDS was considered taboo because it related to sex and sexuality. Breaking taboos would lead to stigmatization. Education officials were expected to talk about sex and sexuality in relation to HIV/AIDS prevention education, according to MOE directives, but were constrained by cultural taboos.

The benefits of having the local Chief participate in HIV/AIDS school-based outreach activities is clear. When the Chief participated in college lectures, it made a positive impact and seemed to contribute to increased participation of parents and other community members. Their spiritual power as potential agents of change indicated and illustrated the importance of cultural artifacts, the significant other, as mediating tools. The diverse environmental landscapes and living conditions of each local community reflected the variety in practices particularly in terms of understanding the drivers of the epidemic. The need for a localized prevention strategy that was relevant to learners in different areas became a paramount concern.

The lack of a coordinated and holistic approach between NAC and MOE’s HIV/AIDS prevention strategies at the national level, and MOE’s absence in the processes and initiatives run by NAC, created a complex and uncoordinated responsibility for the HIV/AIDS implementation from national to local level institutions. The lack of information and participation from central to local level actors was identified as a major primary contradiction within the education sector; The School-community’ rules and division of labor. The MOE employees, the principals and the teachers expected to implement the policies, were uninformed about the existing HIV/AIDS prevention education policies and strategies, as was the case with PTA members. This illustrates a contradiction between two domains, the rules and division of labour, here reflecting a secondary contradiction.

Engeström’s four core contradictions were reflected in the accounts of stakeholders during the inception period, and Table 10.1 identifies some of the core contradictions and their manifistations.

The primary and secondary contradictions are within and between the different domains within and across the two interacting activity-systems (some representing a polyphony of contradictions). Externally driven strategies, here e.g. duplicating HIV/AIDS prevention strategies, so-called tertiary contradict-tions, as well as quaternary contradictions, reflected through external and opposing strategies. The perceptions and experiences of the HIV/AIDS preven-tion education context and discourses were clustered around the four core contradictions - primary, secondary, tertiary and quaternary (as listed in Table


10.1) reflecting the dissonances, gaps, mismatches between policies and strategies and people’s experiences of reality.

Table 10.1 Type of contradictions, characteristics and their manifestations

Contradictions Characteristics Manifested through

Primary Contradictions: within each corner, (double bound)

Notions of WK or IKS ways of perceiving and behaving, causes and effects related to the HIV/AIDS epidemic.

Dilemmas on whether to adhere to cultural norms and traditions or follow scientific knowledge and recommendations regards the epidemic.

Secondary contradictions, between the corners of the activity systems

HIV/AIDS policy (rules) and the implementation of it (division of labor).

HIV/AIDS policies (rules) and mediating tools (polyphony: cultural hindrances, lack of teaching materials, lack of teacher training).

Tertiary contradictions, new object of activities

The taboos and stigmatization of people living with or discussing HIV/AIDS in public, versus openness.

Applying the new object of activity.

Quaternary Contradiction, parallel and conflicting objects of activity

The 5 minutes approach being enhanced by INGOs, CBOs and faith based, in contrast to existing national policy described as a localized approach in the teaching manual on interactive methodologies for HIV/AIDS education.

Confusing and unclear messages to school-principals: e.g. HIV/AIDS as a cross-cutting versus a time-tabled subject, insecurity and conflicting messages hindering the implementation.

In summarizing the contradictions revealed during the program inception, the baseline surveys revealed the main contradiction between the two interactive systems - cultural traditions versus scientific and rational approaches to HIV/AIDS mitigation. The absence of involvement by Chiefs exacerbated this key contradiction. The culturally sensitive nature of the topic, the lack of shared information on policies and support initiatives on HIV/AIDS preventive education within the education sector and lastly, the lack of coordination and shared objectives created additional contradictions.

The baseline surveys illustrated how the meso-, exo- and micro level actors perceived the MOE’s HIV/AIDS prevention education. The micro-level (local


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level actors,) did not have the required communication with exo-level (MOE). This was reflected through the ineffective interactions at the meso- and exo- level contributing to a mismatch between intended macro-level policies\strategies and grassroots level actions. At the same time, traditions and IKS were not taken into consideration, contradicting the ongoing mitigating strategies.

Program development: National and local challenges and innovations emerging from participatory processes

Findings from the initial baseline surveys revealed a lack of local level involve-ment. Moving forward, a broad participation between a range of stakeholders, including the traditional leaders and staff from the education sector, was agreed to as an alternative way forward. This proved to open up new modes of working across and within each of the two activity systems scrutinized in this research: the traditional community and the school community. In contrast to the top down approach to HIV/AIDS preventive education spearheaded by MOE, a bottom up approach, a new object of activity, a localized HIV/AIDS education prevention strategy was developed and implemented. It was based upon dialogue and interaction across the two activity systems where the diverse groups of stakeholders collectively identified the baseline situation, the needs and gaps, assessed optional strategies and ways forward through the facilitating of joint planning workshops, capacity building activities, and monitoring and evaluation procedures. Sharing ideas and reflecting upon ongoing practices related to HIV/AIDS transmission, the spread and mitigation of the epidemic, rooted in local experiences and context were approaches similar to the principles of expansive learning (Engeström 2001, 2008).

The processes and activities that defined the ISACA approach were mediated through a range of multivoiced activities, indicated as primary tools or artifacts. The various ISACA sessions represented the expansive learning spaces, where sharing, mutual understanding, intentional reflection, innovation and learning were introduced through explicit mediation by the core ISACA team.

The different world views, social norms, traditional rituals and taboos e.g. secondary artifacts (Cole, 1996), were given a space to be openly questioned and discussed with the support and thereby explicit approval of the chiefs . New knowledge was constructed based upon multivoiced interactions. Scientific knowledge and analytical evidence were contrasted with existing gender roles, taboos and violating practices. Contradictions were identified and negotiated and gradually turned into innovative and alternative solutions to reduce, alter or eliminate practices enhancing the spread of the epidemic.

MOE policies (2001-2003) required a scientific approach with open dialogue; however, teachers, who were to implement the policies, contested to this approach. Their ambiguity, due to existing cultural and traditional practices


regulated through customary laws, taboos, stigmatization and patriarchal structures posed contradictions to effective implementation.

HIV/AIDS prevention education through formal education was another goal-driven activity involving tools or artifacts to mediate the teaching or integrated school and community activities. The various contradictions found their solutions, interactions, and innovative negotiations among the stakeholders. The contradictions and possible solutions evolved during the processes of the core program activities. The stakeholders involved were able to reach these solutions through core program activities including planning, capacity building, annual monitoring/evaluation, and field visits.

Table 10.2 displays some of the main contradictions, as revealed in the baseline survey and implementation of the program over the course of six years. Solutions that evolved out of the processes are included in the last column.

Actors from two interacting activity systems, the School Community and The Traditional Community developed the new objects of activity through collaboration and coordination.

MOE employees through the core team at province level coordinated the main program activities, and ensured close collaboration with relevant external NGO partners engaged in HIV/AIDS sensitization within the districts and schools. The Chiefs initiated activities within their Traditional Community, from the House of Chiefs to village level. Utilized both activity systems, through their institutions, organizational bodies and relevant stakeholders would, through the various initiatives, as a social vaccine, mitigating the spread and impact of the epidemic.

The PEO level officers provided financial support through MOE funding bodies, and the overall mandate was to ensure children and teachers had the knowledge and skills to prevent themselves from contracting HIV/AIDS and reduce stigmatization and taboos. That would require a strategic training of DEO representatives, principals and teachers, to guarantee a HIV/AIDS prevention education based upon MOE policies and strategies.

The chiefs, the spiritual leaders, were acting as the significant other (Weertch, 1998), and their contribution proved to be an important mediating tool or artifact in the HIV/AIDS prevention approach analyzed in this study. Their role in giving permission to break cultural taboos and in leading the transformation of cultural artifacts and tools in the service of preventing the spread of HIV/AIDS and caring for those with the disease informed the central themes of the approach. By leading cultural change important for reducing the drivers of the spread of HIV/AIDS, the target audience was free to open up and participate in the approach to HIV/AIDS prevention that would ultimately lead to behavioral change.


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Table 10.2 Contradictions and solutions evolving out of program activities.

Type of contradiction

Contradiction Solution

Primary Contradiction (Double bound)

Principles Opening Up, talking about HIV/AIDS as required by DEBS versus, follow the cultural norms, being silencing, follow cultural norms

Talking about the HIV/AIIDS context and impacts

Primary contradiction

Adhere to cultural norms and traditions on HIV/AIDS issues versus applying to Scientific rational knowledge to prevent the epidemic

Gradually applying Western knowledge on prevention thereby changing the cultural practices e.g. from sexual cleansing, to cleansing through transformed rituals

Primary contradiction, (polyphony of contradictions)

Roles and practices, division of responsibilities through school-and community collaboration.

Close collaboration between the two interacting systems towards a common object of activity

Secondary Contradiction

Multiple contradictions related to school and community collaboration

Enhancing collaboration with the various actors

Tertiary contradiction

From 5-min approach, towards application of MOE (2003) strategies

Teaching HIV/AIDS as a timetabled activity in school, the new object of activity

Quaternary Contradictions

Neighboring contradicting HIV/AIDS approaches/messages delivered by different external actors, e.g. Confusing learning conditions

Commonly agreed localized strategy, and monitoring and evaluation procedures

Quaternary contradictions

NAC HIV/AIDS centralized strategies opposed to MOE decentralized strategies

Confusing information messages at district and school level on the HIV/AIDS education prevention y, funding and implementation strategy

Quaternary contradictions

Vertical versus horizontal coordination and collaboration

Applying a horizontal approach to coordination and collaboration between the activity systems at lay

Where the chiefs questioned and contested the initiation rites, and challenged the parents to discuss sexuality and HIV/AIDS with their children, the role of initiation with rites that put young people at risk of contracting the disease were changed, and in some cases eliminated. As parents’ participated in the approach,


they became more informed, and gained permission from their traditional leaders to take responsibility for their children’s growth and maturation, new cultural patterns emerged. Gyekye (1996) argues that transformation and cultural change occurs over time, but the first step is for a generation to question the value of the traditions and practices itself. In this debate, that is exactly what the participants did. Contribution of the various stakeholders, including the pupils’ opinions and voices, shows how powerful such a horizontal and vertical learning actually might be.

Cultural and traditional protocols and norms were adhered to by the facilitators, in this case, the Zambian MOE program coordinators, when facilitating program activities. The approaches and processes reflected the epistemological lenses and worldviews of the participants when negotiating and agreeing on a common vision of the new object of activity. In so doing, the horizontal interaction across traditional boundaries and activity systems can contribute to cultural border crossing, new innovative practices and cultural and educational transformation. We therefore agreed that MOE, through the HIV/AIDS coordinating team should coordinate the intervention, in order to ensure the close collaboration between the partners from the two activity systems, including possible other local partners.

The participants engaged in actually “voicing and naming their world”, where they collaborated in terms of their “here and now”, their present, existential, concrete situation (Freire, 1972 in Collins, 2011, p.105). Such a process contributes to an active conscious engagement changing both the world and the acting subject in an emancipatory direction (ibid., Chambers and Pettit, 2003). The inclusive and participatory process further illustrates what Smith (2007) describes as a decolonizing approach enabling everybody to take the perspective of the other.

The views and knowledge presented by the various participants, from the traditional leaders, the MOE employees, NGOs, pupils, teachers, parents, professionals and novices during the introductory workshops, created a learning situation where traditional knowledge and practices were challenged and contested in the context of new knowledge of HIV/AIDS, its drivers mitigation strategies, education policies and practices.

At the global level the study revealed that UNAIDS and PEPFAR, two influential global actors on HIV/AIDS prevention initiatives, both imposed strategies that were misaligned with Zambian national strategies and contextual realities in regards to HIV/AIDS preventive needs and priorities. UNAIDS required the establishment of a cross ministerial national commission, NAC, that in the Zambian context turned into a highly centralized body in contrast to the overall decentralizing efforts within MOE policy and strategies.

The lower level institutions found USAID’s funding mechanisms too complicated to use and led to delays that hindered implementation of HIV/AIDS preventive activities at lower level institutions. In addition, USAID had one global monitoring mechanism where indicators were mismatched with


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what was identified as the main drivers of HIV/AIDS in Zambia (UNGASS reports) and could not be applied to measure existing local or national level interventions. In 2005, Access to PEPFAR suddenly required a change in the overall Zambian strategy, excluding the condomizing approaches, which were a key component of the national Zambian prevention strategy.

In these examples, the external global funding bodies did not align with the overall national policies, strategies or contextual realities in Zambia, causing confusion and challenges for the actors who depened upon these funds and further illustrates the negative impact of the application of global strategies. The approach of global actors as revealed in the study, seem to follow the top-down practices reflecting the historical applications of blueprints and to be “more of the same” in development assistance as argued by Easterly and Klees in their critique of global plans.

Outcomes, new objects of activity: The ISACA approach: structural and organizational change artefacts, rules and division of labour The creation of the new object of activity can be categorized as:

� Structural and organizational change in the HIV/AIDS prevention in the province to include broad stakeholder involvement and horizontal collaboration between two interacting activity systems

� Cultural change and transformation � Implementation of interactive methodology of HIV/AIDS education

through school and community level collaboration. These interventions have been described in detail in previous chapters, here some findings and their implication for future development work is highlighted. The ISACA approach to HIV/AIDS education that evolved out of the program was conducted and mediated by local actors. They all adhered to cultural protocols, using the same “language” and visioning the new objective of activity within the cultural concept of Ubuntu.

During the planning procedures, agreed upon rules were applied across all districts and reflected the same principles of multivoiced collaboration and coordination using the existing structures and resource personnel. Capacity building and learning took place within and across all the participating actors and institutions. After the interventions, the MOE employees and other participating actors sustained their new knowledge.

The division of labor was characterized by coordination and a shared responsibility between the key actors in the two activity systems, the workshops were carried out collaboratively, between MOE staff down to the classroom and community levels. Throughout, Chiefs collaborated closely, sometimes through their HM.


At school as well as at village level the traditional leaders’ influence was of equal importance. Their involvement and participation showed the head teachers, the teachers, and the pupils that they, through their engagement, deemed educational settings as safe zones for talking about sex and the HIV/AIDS pandemic. By working hand in hand with the chiefs, supported by MOE, the stigma was significantly reduced. This enabled teachers at schools to gradually move away from “the 5-minutes approach” to more interactive teaching practices that allowed the discussion of HIV/AIDS related topics, previously taboo.

Schools and their teachers worked with the Chiefs to improve the link between the schools and the parents, e.g. the wider community. As a result, better learning environments were created. Pupils were re-socialized, as Hoem and Darnell (1996) would argue, strengthening the content and impact of the HIV/AIDS messages, and enabling the pupils to disseminate HIV/AIDS information to their peers and parents. Teachers were gradually able to include relevant cultural aspects in their teaching, and the pupils contributed with their own experiences and views in their classroom interactions.

The artifacts or tools mediating the transformations and changes are categorized below according to the theoretical concepts borrowed from Cole (1996). The chiefs emerged as key influencing actors, or significant others, contributing heavily to breaking or bending cultural barriers. As custodians of culture and tradition, who hold a mandate from Zambia’s House of Chiefs, there was no doubt about their legitimacy as leaders in their respective kingdoms and villages. This position empowered them to act as role models and gate openers. By “opening up”, talking openly about HIV/AIDS, the means of contracting and spreading the disease, and ultimately actively intervening to mitigate HIV/AIDS by using culture as a tool, the Chiefs used their power and position to transform culture to protect their subjects, or villagers. They led the way in changing cultural practices and fighting taboos. They also freed their followers to break the taboo, encouraging dialogue and interaction about drivers and mitigating strategies to reduce the spread of HIV/AIDS.

As the significant other, auxhiliary artifact, (Cole, 1996) the chiefs played a crucial role for local development. In a society where traditional cultural norms still dominated peoples’s world views and daily activities, trust and legitimate power as argued by Hofstede (1996) and Inglehardt (2005) play a much stronger role than in countries where cognitive and scientific knowledge dominates behavior and thought. Zambia, a collectivist society, built upon sisterhood and brotherhood and trust among insiders, illustrates how culture actually contributes to and represents the mediating tools and artifacts in contexts where spiritual and indigenous knowledge dominate the daily activities and norms guiding peoples’everyday activities, thoughts, and ethics. As explained by Cole (1996), culture controls and mediates peoples’ behavior and is a powerful means to mediate change, aligning to cultural practices and protocols when emphasizing change and transformation.


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Tertiary artifacts, rites like sexual cleansing and the subordination of women, including the traditional cleansing and initiation processes were also abolished by the chiefs. Chiefs used their parliament, with their senior head men/women, and developed alternative rites, such as abolishing discriminatory content and praxises in the initiation ceremonies, and replacing sexual cleansing with herbal baths or back rubbing. As argued by Gausset, it is not a matter of abolishing culture, but a matter of preventing the spread of HIV/AIDS by adhere to safe behavioural patterns. The approach developed fully realized the importance of keeping up with the traditional rites, but at the same time abolished practices that were detrimental to their subjects. Chiefs transformed culture to keep their people safe.

10.2 Contributions to development research and practice

Cross disciplinary research methods

This study used multiple research methods in a qualitative research paradigm across methodological traditions and professional boundaries, which enabled the creation of new knowledge contributing to a broader understanding of development work. By combining CHAT and constructivist grounded theory, the study was able to increase the analytic possibilities that led to robust explanations about cultural and social transformations (Seaman, 2008)

The complementarity of these main methodological approaches provided synergy for analyzing sociocultural activities that have received little attention where closer insights are desired. Developing a constructivist grounded theory on the basis of activity is a powerful approach to research seeking greater ecological validity, as argued by Bronfenbrenner (1989), as this kind of grounded theory of activity might be developed and employed at different levels of analysis and along different time scales depending on interest. By adopting a constructivist grounded theory approach to activity theory research, the researcher was able to place herself in a dialectical relationship with the data, as well as with a theoretical point that offered methodological guidelines and assumptions. Constructivist grounded theory’s compatibility with CHAT is best exemplified through the way in which CHAT provides tools for analyzing findings emerging from constructivist grounded theory. This complementarity generates new insights into activity-based research.


CHAT, power, symbolic control and transformation

The two main interacting activity systems in the study are built upon different epistemologies, the rational, western scientific perspective, in contrast with the cultural, spiritual and indigenous perspective.

By using Engestrôm’s (1987, 2008) CHAT, and Bernsteins’ (2001, 2010) concept of regulative and symbolic control the study reveals a deeper understanding of learning and transformative action at both individual and system level. Engeström (1987) argues that the main contradictions in any activity system are related to three dominant aspects of human activity - production, distribution and exchange, where exchange and use value are the main contradictions.

Bernstein argues, in his critique of Engeström, that the main contradictions are to be found in what guides the behavior, and determines and mediates people’s way of living. According to Bernstein, this is symbolic control. Bernstein’s (2010) and Daniels’(2012) theories thereby give an added dimension to CHAT, highlighting the symbolic control of culture, as well as academic and scientific power, both being important dimensions as integrated parts of the processes underlying any human interaction. They introduce symbolic power, as a regulating and controlling force as the mediating artifacts. The dialogues and the interactions, the processes scrutinized in the study, were clearly influenced by the regulating power of cultural and spiritual artifacts; the primary, secondary and tertiary mediating artifacts reflected in culture and traditions (Bernstein, 2010). According to Bernstein, this constitutes symbolic power. In this study, the symbolic power of culture manifested itself in the way cultural artifacts mediated peoples’ lives, how culture guided and controlled their activities, as well as their new learning and behavioral patterns. This is illustrated in Figure 10.3.

Engeström’s third generation of CHAT and Bernstein’s concepts of regulative and symbolic power as further elaborated by Daniels, complement each other. By merging these theories, both building upon a constructivist and Vygotskian theoretical framework, we can come to an even broader understanding of how horizontal interaction across traditional boundaries may occur. Where Engeström focuses on the outcomes of these processes, Bernstein focuses on the underlying interactive processes that are brought into play. In contrast to Engeström, Bernstein specifically focuses on the importance of power when addressing the processes of development.

This study, revealed that transformation and change are based upon underlying power relations, symbolic power; a power struggle between spiritual versus academic/scientific powers. Through explicit mediation and a broad participation of stakeholders representing different symbolic aspects of control, the spiritual versus scientific powers, the merger and local application of IKS and WE manifested itself through the new object of activities, the transformed practices.


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the Y-axis moves from traditional to a more advanced and complex societal order. A dynamic connection exists among the quadrants.

Each quadrant (Storper,1996, in Virkunnen et. al., 2010), represents different ways of viewing and understanding development. Actors come from different “worlds”, from the professional education institutions, from experts and novices, to local chiefs and headmen, representing different levels and layers of the society. Every “world” has culturally developed conventions, concepts and practices of managing interactions between and within its own constituency.

The four worlds in Figure 10.4 differentiate between knowledge based upon the historical and cultural development of expertise through IKS in quadrant Two. Competencies and skills needed to go beyond the existing understanding of the phenomenon, using a scientific and rational epistomological understanding are in quadrant One. Quadrant Three reflects the world of global developmental strategies, and quadrant Four illustrates the world of multivoiced horizontal collaboration and development across professional borders and activity systems.

People need to find local solutions to their problems. It is therefore of great importance to learn to work with local people to identify what are the best approaches to take. What cannot be dismissed when dealing with any individual or societal problem, is culture. Culture in all forms guides and even controls the behavior of populations. It is therefore vital to understand what matters to people, and to respect them, wherever they are.

This underscores the need for in depth contextual understanding in order to apply culturally relevant and appropriate approaches to development work and/or research. A key contribution to research derived from this study is the need for development efforts to embrace multi-voiced and participatory planning and processes, utilizing existing scientific knowledge to build upon local traditions and knowledge in order to reach relevant and appropriate responses.

Use of participatory and multi-voiced responses and facilitation within local protocols develops trust and acceptance. Decolonizing methodologies Smith (2008) that focus on respecting and recognizing local voices and providing opportunities for an equal stake in their own development, are empowering strategies that create local ownership. These approaches anchor and sustain new development and transformation, as revealed in this study in community and village development contexts.

Rapid changes through new technologies, disasters including climate change or epidemics like HIV/AIDS and Ebola, require knowledgeable and skilled professionals to effectively address challenges throughout the world. These professionals will also have to build upon the existing knowledge and needs as experienced by those acting upon new requirements. This move can be illustrated by the vertical axes moving from traditional practices to a more advanced or new objective, as illustrated in Figure 10.4. The concept of professional education will also have to reflect these new requirements.


Professional HIV/AIDS education that uses for science and of local cultural approaches and attitudes will be more relevant and sustainable.

Rapid local, national and international changes require responsive environments that can build upon and merge the various knowledge systems to reach transformative agency and motivation in order to find unified solutions to the challenges facing societies and communities. Reaching solutions to challenges requires professionals who embrace openness and a willingness to deliberately contest and go beyond the given order and status quo in the activity in which the subjects are involved. These processes ultimately include new learning, explicitly and implicitly. Tracing the evolution of learning through horizontal collaboration across professional borders and activity-systems manifested through the expansion of the object of activity, and through decolonizing approaches will ultimately contribute to a broader understanding of future development work. This leads us to understand how local structures can be further explored and cultural strengths and indigenous knowledge can be used to bring about positive, contextualized change and transformation.

Summary of the Study

Theses overview

Introduction It has been more than 30 years since the Acquired Immunodeficiency Syndrome (AIDS) emerged as a major health emergency, with the epidemic having had a serious and devastating effect on national as well as human development. The scale of the epidemic’s impacts, highly varied from place to place and country-to-country, have been documented with increasing precision over the years as surveillance and analytical tools have improved. As a result, the interrelationship of AIDS with other problems of human development has become clearer.

Socio-cultural, economic, and legal factors exacerbate the spread of HIV and heighten the impact of HIV/AIDS. In almost all cases, poor and socially marginalized people are disproportionately vulnerable to HIV/AIDS and its consequences. The United Nations (UN) Millennium Declaration highlighted the interconnectedness between development goals and the need to address the causes of vulnerability to HIV/AIDS and its impacts, by alleviating poverty through sustainable development, the promotion of gender equality and access to education.

Zambia was among the countries hardest hit by the epidemic with an infection rate of 15-20% of the population in 2000. The majority of the population was either infected or impacted by the HIV/AIDS epidemic as stated by the majority of respondents. They were living with the HIV/AIDS epidemic as a daily threat, and the reality of the disease and its consequences for their communities, schools and families.

The present study is concerned with the challenges faced by politicians and educationists, including teachers, in actually reaching out to the learners and the communities with HIV/AIDS prevention activities. The study scrutinized is based upon data compiled during the development and implementation of HIV/AIDS prevention education program based upon the overall national policies and strategies in one province of Zambia, from 2002 to 2008.


The study has three main objectives: a) To explore the contextual realities of the HIV/AIDS epidemic and

how the Ministry of Education (MOE) HIV/AIDS education strategies was perceived, experienced and practiced during the time of the project inception.

b) To identify how a broad participatory stakeholder involvement could bring out innovative HIV/AIDS strategies to mitigate the drivers of the epidemic responding to the contextual realities.

c) To explore how culture can mediate change and create local innovations through expansive learning across professional and cultural traditional boundaries and borders.

Context

Since the mid 1980’s HIV/AIDS has been a global concern. The social, economic and developmental impact of the epidemic in Sub-Sahara African countries has been severe at regional, national as well as local and individual level. Combating HIV/AIDS has been a top priority in the development aid discourse since the mid-nineties, and has included the most influential funding agencies globally through the United Nations Program on HIV/AIDS (UNAIDS). The global framework coordinated by UNAIDS, the study argues, promotes top-down approaches with conditions at national level that are difficult for most developing countries to meet. The global eligibility framework, for example, forces the countries to apply to the ‘Three Ones’; one national AIDS coordinating authority, one broad-based multi-sector mandate, and one agreed country level monitoring and evaluation system. Furthermore, the health sector maintains its predominant role in fighting HIV/AIDS, through treatment, care and prevention initiatives. This is inconsistent with other global agendas and frameworks like Education For All (EFA) and the Millennium Development Goals (MDGs) where the education sector is clearly spelled out as an important actor in HIV/AIDS prevention activities. These top down approaches, it is argued, have proven to hinder effective funding particularly in reaching out to the grassroots with local level intervention, also related to the implementation of MOE`s HIV/AIDS mitigation strategies.

Even though the cultural and traditional practices as well as structural factors are fueling the spread of the disease, the lack of consideration for these important elements in HIV/AIDS prevention strategies initiated by the global actors is problematic. Zambia, being one of the poorest countries in Africa where highly depending upon external resources to address the massive problems within the country. Unfortunately, the ways in which the global plans are structured work against some of the national strategies. In the case of Zambia, a decentralized, bottom up, approach to education was emphasized in order to


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enhance the implementation of locally relevant and likely, more effective strategies.

There are some key lessons learned regarding the role of education in HIV/AIDS prevention. The first is that people in general benefit from extended years of schooling, showing a reduction in HIV/AIDS infection rates and safer sexual behavior. Implementing HIV/AIDS education prevention also reveals promising results, having an additional impact in reducing the spread. UNESCO (2011) argues, however, that there are too few countries having implemented a systemic approach to mainstreaming of HIV/AIDS education and been able to follow up with the necessary assessment of impacts on behavioral changes.

HIV/AIDS education needs a comprehensive approach that includes both the formal education sector as well as the non-formal and informal sectors. The role of the teachers are crucial. The introduction of HIV/AIDS education in the curriculum needs to be complemented by the professional development of teachers (GCE, 2005, Global Monitoring report, 2008) and enable them to go beyond the scientific and selective mode of teaching to apply a more situated approach embedding the topic in the local context of the learners is key.

Education is also considered “the social vaccine” (Kelly, 2000) that can provide children with the knowledge, attitudes and skills required to make healthy choices about when and how they have sex, and to develop respect for themselves and others.

The epidemic has been known in Zambia since the early 1980s, with a peak in new incidences in the early 1990s. While the rate of incidence from then on has been fairly stable, a disproportionate number of especially young women have been affected.

Knowledge among the population of transmission and prevention of HIV/AIDs has been characterized by misconceptions. According to Zambia’s National AIDS Commission (NAC) (2010) only 35% could identify ways of preventing HIV/AIDS transmission. The fact that the largest proportion of the infected population is between 25 and 40 years, when young people are in their productive age, actively utilizing their education, skills and opportunities for individual and societal development, has had devastating impacts on the social well-being within families, and negative consequences for Zambia’s economic development

There has been a steady increase in the number of children having access (close to 90 percent enrolment) to and completing school (MOE, 2008). Given the increase in access and completion at the basic education level, there are good reasons to argue, that reaching out with relevant and quality HIV/AIDS education, would directly target the majority of the age group between 7 and 15 years old. Using the education structure to reach out to children and youth with HIV/AIDS preventive education, would be a means to bridge the information gap identified.


The new syllabus (MOE, 2002, 2003) and the HIV/AIDS education manuals (MOE, 2003) exposed the cultural barriers and hindrances one faced in bringing about HIV/AIDS education. Traditional practices such as sexual cleansing, initiation, and tattoos, as well as the taboos and stigmas related to even talking about HIV/AIDS and sex in the public are for the first time being addressed in the formal education system.

Conceptual framework

The conceptual framework was developed to explore and understand the processes at play between the global and local dimensions during the development of the HIV/AIDS prevention education in the Zambian context. The framework is based upon a holistic bio-ecological model of development, an approach that encompasses the structural, cultural and constructivist paradigms. An interpretive perspectives and Engeström`s (1987) third generation of Cultural Historical Activity Theory (CHAT), inclusive expansive learning activities, were applied as tools to identify, analyze and try to understand how the HIV/AIDS education prevention strategies were developed, implemented and perceived among multiple stakeholders in Southern Province. The multiple levels approach clearly illustrates the dual relationship between the macro and micro level influences to HIV/AIDS prevention strategies.

To understand the dynamic on how societies work the link between culture and world-views, the ‘software of our minds’ is crucial. In the African society under discussion the concept of ‘ubuntu’ is identified as a key linking theme in this endeavor, although the dangers inherent in possible polarizations are noted as alternative conceptualizations of learning and communication. Vygotsky’s mediation concept is examined in some detail and its relationship to formal school explored.

The conceptual framework for the whole study is therefore located firmly in a battery of related theoretical concepts which help shed light on the deeper dynamics of change and potential barriers to change within a society such as Zambia.

Methodology

The HIV/AIDS prevention education intervention scrutinized in the study was developed and applied in all the 11 districts in the province, comprising about 890 primary schools. The dual role of the researcher, facilitating the project and at the same time conducting the research activities, had advantages related to access to respondents and information at the various levels, and was conducted with the approval by the province education officer, although most of the data were gathered through an overt research approach.


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The multileveled approach required a broad range of methodological strategies, such as field notes, structured and open-ended questionnaires, interviews, document analyses and relevant protocols and newspapers, to mention some. A qualitative and constructivist grounded research methodology were used as complementary approaches, through the active involvement of the respondents through their participatory role in the various project activities.

The grounded constructivist paradigm was complemented with CHAT and a computer assisted qualitative data analyses software, NVIVO, was applied as a tool to structure and support the coding and construction of the core categories identified in the study derived from the large amount of data. Where CHAT emphasize culture and historicity, constructivist grounded theory focus on actions of the individual groups, an approach that according to Seaman further expand the ongoing evolution of grounded theory, and the criteria developed in the study were continuously expanded. The multileveled and participatory approach correspond to Smiths`s concept of decolonizing methodologies by acknowledging the various world-views and epistemological lenses.

Drivers of HIV/AIDS

The key to understanding the spread of HIV/AIDs is to understand the factors fueling it. The main mode of transmission of HIV/AIDs in Zambia is through heterosexual sex accounting for about 80% of all infections. It is exacerbated by high-risk practices, socio-economic inequalities, as well as the high prevalence of untreated sexually transmitted infections. The structural and cultural drivers of HIV/AIDS in Zambia, some quite overlapping, are related to the subordination of women including the reduction of girls’ and women’s ability to negotiate sex, and the related issues of the limited power to deny sex to husbands, relatives and others. This is further fueled by inadequate protection under statuary and customary law. In addition the poor socio-economic status of women and girls, particularly widows and orphans pushes them into prostitution which further increases their risk factors.

In addition to the above mentioned factors, MOE (2004a) also add cultural rituals and traditions as risk factors for contradicting HIV, stating that polygamy, ritual cleansing, traditional medicine, dry sex, land inheritance and customary laws as practices that often result in circumstances increasing the likelihood of transmitting HIV. Traditionally it is taboo to discuss sexual matters with somebody from the opposite sex, and even then it was hardly talked about, but viewed as a taboo. Therefore people rarely speak about HIV, not even with their own children. The common term used was “we are not comfortable talking about it”, as “opening up” in most instances would result in stigmatization.

The cultural drivers and the misconceptions related to HIV transmission and prevention as revealed in the study highlighted the need to include the local leaders, in order to develop relevant community driven approaches. A close


collaboration between the community members, including the parents, and the local schools were also endorsed in the existing HIV/AIDS syllabi (MOE, 2003) as a HIV/AIDS mitigation strategy at the local level.

Role of traditional leaders

The Zambian local leaders`, also termed chiefs`, have a formal role in the development of their chiefdoms, or kingdoms. Their role were regulated by law at national level through the House of Chiefs, being the custodians of culture and traditions. The chiefdoms vary widely in size and have their own characteristics, structures and development prioritizes depending upon location and historical development. Some chiefs were afraid of going against their own traditional practices. The most influential chiefs in the province, having a seat in The House of Chiefs, were at the contrary very concerned about HIV/AIDS and its negative impacts on their chiefdoms. They were directly involved in the intervention from its inception, being gate-openers and taking on a developmental approach, applying to new knowledges on HIV prevention in order to improve the conditions for villagers and their chiefdom. The importance of mitigating HIV/AIDS was endorsed in spite of the fact that it might include transformation and change regards traditional customs, rites and practices.

The chiefs fought the epidemic in different ways, but their strategies are categorized under the umbrella of “a social vaccine”. Their actions can be clustered as interventions within their chiefdom, within the structures of House of Chiefs, and lastly, as collaborating partners across the two different activity systems at play, e.g. The School Community, comprising the institutions and actors within MOE, and The Traditional Community, including the traditional leaders, their parliament and local parliament members, head men. The chiefs` agency as legitimate leaders and role models had an important impact within all their various mitigating interventions.

HIV/AIDS prevention prior to the project intervention

Prior to the start of the HIV/AIDS education interventions scrutinized in the study, there were numerous non-formal mitigation initiatives targeting different sectors and levels in Zambia run by different non-governmental or faith-based organizations. The global UNAIDS strategy and the national MOE HIV/AIDS strategy were both initiated in 2002 and were implemented through national structures and agreements. The UNAIDS program had a multi-sectoral and cross-ministerial approach, including HIV/AIDS education prevention. The MOE strategy was a central component within the Basic Education Sub Sector Investment Plan (BESSIP) a multi-donor education program in support of Zambia.


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The lack of a coordinated and holistic approach between NAC and MOE`s HIV/AIDS prevention strategies at national level and MOE`s absence in the processes and initiatives run by NAC, created a complex and uncoordinated approach to the HIV/AIDS implementation strategy in education from national to local level institutions. The lack of information and participation from central to local level actors was identified as a major hindrance according to MOE`s own rules and regulations., or primary contradiction to use Engeström`s terms.

The project’s baseline surveys conducted before the new intervention took place, revealed that the stakeholders, from MOE officials at district to school level, were unaware of the existing policies and strategies on HIV/AIDS prevention education being promoted by these national programs. They saw the importance of applying HIV/AIDS prevention as a part of the curriculum, but did not know how to carry it out. They lacked information, had not been consulted, and hadn’t received any training.

Findings from baseline meetings with principals, and school and cluster visits revealed how they viewed the sociocultural and contextual conditions as drivers of the virus. One major barrier was the taboo about talking openly about HIV/AIDS, as it related to sex. Breaking that taboo, according to the stakeholders would lead to stigmatization. MOE directives emphasized talking about sex at school yet, principals and other school actors were at the same time constrained by the cultural taboos, another major contradiction related to effective HIV/AIDS prevention. The diverse landscape, environmental and living condition of each local community illustrated how practices and contexts varied, also when discussing the driver of the epidemic reflected the need for a localized prevention strategy to make them relevant to the learners.

The baseline surveys illustrated clearly how the meso-, exo- and micro-level actors perceived the MOE`s HIV/AIDS mitigation initiatives, and reflected how the macro issues impacted the actual implementation of the intended policies and strategies at the grassroots e.g. school and community level.

Multi-voiced planning and negotiations of interventions

The study shows the power of participatory and horizontal integration of stakeholders in addressing the HIV/AIDs challenges through inclusive planning processes that led to localized interventions. The chiefs, the spiritual leaders, were acting as the significant other, as defined by Weertch, and their contribution proved to be an important mediating tool or artifact (Cole, 1996) in the HIV/AIDS prevention approach analyzed in this study. As role models and gate openers they publically were breaking the cultural taboos. By sharing their ideas on traditional, although risky practices as possible drivers of the pandemic, they took a lead in openly discussing changes preventing the spread of HIV/AIDS and the importance of caring for those with the disease, the central themes of the HIV/AIDS approach.


The existing worldviews and cultural norms and traditions characterized as a secondary artifacts, including the taboos and the stigmatization of those breaking these, were viewed as the key constraining factor in mitigating HIV/AIDS. Where the chiefs were taking an active role in promoting cultural change, opening up and taking an active stake in the strategy, their contribution played a crucial role, as it legitimatized the participation of the villagers, including pupils and teachers in the approach to HIV/AIDS prevention.

By questioning and contesting the initiation rites, and challenging the parents to discuss sexuality and HIV/AIDS with their children, the role of initiation with rites that put young people at risk of contracting the disease were changed, and in some cases eliminated. As parents’ participated in the approach, were more informed, and gained permission from their traditional leaders to take responsibility for their children’s growth and maturation new cultural patterns emerged. Gyekye (1996) argues that transformation and cultural change occurs over time, but the first step is for a generation to question the value of the traditions and practices itself. In this debate, that is exactly what the participants did. Contribution of the various stakeholders, including the pupils` inputs, shows the power of a broad stakeholder involvement and horizontal learning.

Cultural and traditional protocols and norms were adhered to in these processes based upon involvement and the voices of the different actors themselves, reflecting their epistemological lenses when negotiating and agreeing on common vision of the new object of activity. In so doing, they engaged in horizontal interaction across traditional boundaries and activity systems contributing to cultural border crossing, the generation of innovative practices and cultural and educational transformation.

Through facilitation the participants engaged in actually “voicing and naming their world”, where they collaborated in terms of their “here and now”, their present, existential, concrete situation (Freire, 1972). Such a process contributes to an active conscious engagement changing both the world and the acting subject in an emancipatory direction (ibid., Chambers and Pettit, 2003). The inclusive and participatory process further illustrates what Smith (2007) describes as a decolonizing approach where participants were enabled to take the perspective of the other.

The views and knowledge presented by the various participants, from the traditional leaders, the MOE employees, NGOs, pupils, teachers, parents, professionals and novices during the introductory workshops created a learning situation where traditional knowledge and practices were challenged and contested in the context of new knowledge of HIV/AIDS, its drivers, mitigation strategies, education policies and practices. The learning process illustrates the first steps in an expansive learning cycle, as it is termed by Engeström.

The participants were questioning the existing practice regarding the spread and prevention of HIV/AIDS, they identified primary and secondary contradictions based upon knowledge sharing, discussions and negotiations, and


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came up with ideas, that were modeling a new solution to combat the epidemic in their own districts, developed a new object of activity.

It was established a HIV/AIDS coordinating team to ensure the close collaboration between the partners from the two activity systems, the school-community as well as the traditional community activity system, the core collaborating actors. The team comprised three MOE-employees, one representing the province, one the district and lastly one principal from school level, that would work closely with external expert, having the dual role as short term consultant and researcher. The school and community driven approach was targeting teachers, pupils, parents and villagers. It involved traditional and civic leaders, as well as employees within the education sector, non- governmental organizations (NGOs), churches and health clinics where relevant. Representatives from the various institutions and organizational bodies involved were utilized to mitigate the impacts and spread of HIV/AIDS through preventive means.

In 2006, the approach was applied in all districts in the target province. The guiding principles were rooted in a participatory and situated paradigm, reflecting the local contexts and needs. As Collins (1998) argues, these processes are emancipatory and closely related. Smith further characterize the approaches as decolonizing, whereby people`s voices are recognized being equal partners in their own development. In addition to the principle of a broad stakeholder involvement, networking, collaboration and coordination between different professionals, across the existing boundaries, introduced a new approach to HIV/AIDS prevention strategies in Zambia.

The approach mediated and facilitated through workshops, meetings and field visits, created different spaces for interaction and dialogue. This legitimized the education sector with its collaborative partners as a “social vaccine” in the fight against the spread of HIV/AIDS.

Change and transformation

The impacts of the chiefs` direct involvement in preventing the spread of HIV/AIDS within their kingdoms can primarily be characterized as influential gate-openers. They developed a range of interventions within their own kingdoms, but also utilized their position in the House of Chiefs, and also through external social marketing of the projects` various components and strategies, utilizing TV, radio and newspapers.

The chiefs did not abolish culture and tradition, as has been a critical discourses in fighting HIV/AIDS (Gausset, 1997), or eroding or removing the cultural scripts, rites and schemas. They were working hand in hand with their parliament members and found solutions to their challenges through the traditional procedures within each kingdom, using their internal indigenous


processes and structures. Through these procedures, the kingdoms reached to different local solutions. Some few examples is given below:

� by abolishing some of the practices being the drivers of the epidemic, e.g sexual cleansing (cleansing a widow from evil spirits) the chiefdoms turned the rite of cleansing into a renewed practical rite, cleansing by rubbing backs or herb baths. The new practices reduced or eliminated the spread of new infections.

� by questioning and contesting the content and practices used during the initiation seremonies, preparing the young ones for their adult-hood, some of the rites putting young people at risk of contracting the disease were abolished.

� by challenging parents to discuss sexuality and HIV/AIDS with their children, gradually new barriers were overcome.

At district level, a systemic training of MOE employees, including principals and senior teachers, were being conducted. MOE policies were shared and the trained team from each school conducted their own school-based workshops on Interactive Methodology of HIV/AIDS (MOE, 2003) within a scheduled timeframe. The 5-minutes approach was gradually replaced by a timetabled interactive HIV/AIDS prevention education, which in general was highly appreciated by teachers as well as the pupils. Using the local language contributed to reduce gender-biased and discriminatory concepts, and the HIV/AIDS prevention education was conducted in both segregated and mixed classes. Peer education and community-based initiatives were developed locally, according to the conditions and needs at school level.

At district and school level, the various activities were also reflecting their own conditions and priorities as they at both levels, specifically at school level, found their own solutions within the overall iterative HIV/AIDS framework. This was based upon access to recourses and own priorities, their physical facilities, other potential collaborating partners, and also their relationship and collaboration with the traditional leaders. Some individual actors also contributed to resistance hindering a smooth development and implementation of the new HIV/AIDS approach. Support where needed followed up with close continuous monitoring and evaluation of the HIV/AIDS interventions at school level, also created a closer relationship between the schools and the DEO in several instances.

The fact that teachers, students and the community as a whole were able to open up about HIV/AIDS also helped infected teachers to get tested, access ARVs as the stigma gradually were reduced. The same tendencies was experienced among pupils, and the number of re-entry schemes for girls that have given birth were increased. As was the case within the traditional community, also the school community proved to find their own solution to their HIV/AIDS.


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Key findings and contributions to development research and practice

The study reveals that far from being caught or trapped in culture, partners in the HIV/AIDS prevention education program in the study were empowered to use their culture, and historical epistemological lens to find their local solutions to mitigate the pandemic.

By combining CHAT and constructivist grounded theory, the study was able to increase the analytic possibilities that led to robust explanations about cultural and social transformations. The multiple research methods applied to, moving across methodological traditions and professional boundaries contributed to the creation of new knowledge and broader understanding of development work.

The complementarity of these main methodological approaches provided synergy for analyzing sociocultural activities that have received little attention where closer insights are desired. Developing a constructivist grounded theory on the basis of activity is a powerful approach to research seeking greater ecological validity, as this kind of constructivist grounded theory of activity might be developed and employed at different levels of analysis and along different time scales depending on interest. By adopting this approach the researcher was able to place herself in a dialectical relationship with the data, as well as with a theoretical point that offered methodological guidelines and assumptions. Constructivist grounded theory’s compatibility with CHAT is best exemplified through the way in which CHAT provides tools for analyzing findings emerging from constructivist grounded theory. This complementarity generated new insights into activity-based research.

Sammanfattning Summary of the Study in Swedish

Inledning

Mer än 30 år har gått sedan AIDS trädde fram som en viktig hälsoutmaning. Epidemins omfattning hade effekter som varierade stort mellan olika platser och länder. Detta har dokumenterats med ökande precision under de år som kunskapsinsamling och analysverktyg har förbättrats. Som ett resultat har sambandet mellan AIDS och andra problem rörande mänsklig utveckling blivit klarare.

Socio-kulturella, ekonomiska och legala faktorer har påverkat spridningen av HIV och ökat förekomsten av HIV/AIDS. Fattiga och socialt marginaliserade människor är särskilt utsatta för HIV/AIDS och dess konsekvenser. FN:s milleniedeklaration belyste sambandet mellan utvecklingsmål och nödvändig-heten av att ta sig an orsakerna till utsatthet för HIV/AIDS och dess följder. Uthållig tillväxt motarbetar fattigdom, främjar jämställdhet och främjar tillgången till utbildning.

Zambia är bland de länder som är mest drabbade av epidemin, med en infektionsgrad på 15-20 procent av befolkningen år 2000. Majoriteten av befolkningen är antingen smittad eller påverkad av HIV/AIDS epidemin enligt svaren från de flesta respondenterna i studien. De lever sitt liv med det ständiga hotet från HIV/AIDS epidemin och med sjukdomens påtagliga konsekvenser för deras samhällen, skolor och familjer.

Den aktuella studien är fokuserad på de utmaningar som möter politiker och utbildningspersonal, inklusive lärare, i deras strävan att nå ut till elever och samhällen med förebyggande åtgärder mot HIV/AIDS. Studien använder data insamlade från år 2002 till 2008 under utvecklingen och implementeringen av ett förebyggande utbildningsprogram mot HIV/AIDS, baserat på Zambias över-gripande politik och strategier i en av landets provinser.


Studien har tre övergripande syften: a) att undersöka de kontextuella förhållandena kring HIV/AIDS

epidemin och hur de utbildningsstrategier som Ministry of Education (MOE) utvecklat uppfattades, upplevdes och omsattes i praktiken under studiens genomförande,

b) att identifiera hur ett brett deltagande av de berörda kan frambringa innovativa HIV/AIDS strategier för att motverka de orsaker som bidrar till epidemin och anpassa dem till den aktuella kontexten,

c) att undersöka hur man med hjälp av kulturen kan förmedla förändring, skapa lokala innovationer genom ett omfattande lärande som korsar professionella och kulturella traditionella gränser.

Kontext

HIV/AIDS har sedan mitten av 1980-talet varit ett globalt problem. Effekterna på den sociala, ekonomiska och utvecklingen i länderna söder om Sahara har varit allvarliga på nationell, regional, lokal och individuell nivå. Sedan mitten av 1990-talet har bekämpningen av HIV/AIDS varit ett högprioriterat område för utvecklingsbiståndet och biståndsdebatten, inklusive de mest inflytelserika globala biståndsgivarna, genom FN:s program om HIV/AIDS (UNAIDS). Studiens resultat visar att det globala angreppssättet som samordnats genom UNAIDS främjar en uppifrån och ner ansats kopplad till villkor på nationell nivå som de flesta utvecklingsländer inte klarar att uppfylla. För att uppfylla de globala kraven för att vara behörig för bistånd tvingas länderna att acceptera de tre villkoren, en nationell AIDS koordinator och ett evalueringsorgan, ett brett baserat flersektoriellt mandat och ett överenskommet ett nationellt uppföljnings-och utvärderingssystem. Dessutom bibehåller hälso- och sjukvårdssektorn sin dominerande roll i bekämpandet av HIV/AIDS genom behandling, vård och förebyggande initiativ. Detta strider mot andra globala riktlinjer och agendor som Education for All och Millenium Development Goals där utbildningsområdet särskilt utpekas som en viktig aktör i det förebyggande arbetet mot HIV/AIDS. Studiens resultat menar att dessa uppifrån kommande direktiv hindrar effektiv finansiering särskilt när det gäller att nå ut till gräsrötterna med lokalt utformade insatser vilket också är relaterat till MOE:s genomförandestrategi för att bekämpa HIV/AIDS.

Även om de kulturella och traditionella beteendena såväl som strukturella faktorer har bidragit till spridningen av sjukdomen tar man inte hänsyn till dessa viktiga komponenter i strategier för bekämpningen av HIV/AIDS som initierats av globala aktörer vilket utgör ett problem. Zambia, som är ett av de fattigaste länderna i Afrika, är i stor utsträckning beroende av externa resurser för att tackla sina omfattande problem. Tyvärr motverkat det sätt på vilket de globala planerna är utformade några av de nationella strategierna. En decentraliserad nerifrån och

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upp ansats vad gäller utbildning lyftes fram för att underlätta införandet av lokalt relevanta och förmodligen mer effektiva strategier.

En del viktiga lärdomar gjordes vad avser utbildningens roll för att motverka HIV/AIDS. En av dessa lärdomar är att befolkningen i allmänhet gynnas av längre skolgång vilket visar sig genom minskade nivåer av HIV/AIDS infektioner och säkrare sexuellt beteende. Införandet av utbildning för att förebygga HIV/AIDS har också visat lovande resultat med ytterligare effekter på minskad spridning av sjukdomen. UNESCO (2011) anser dock att alltför få länder infört en systematisk, integrerad utbildningsinsats om HIV/AIDS och lyckats med att följa upp denna med nödvändiga utvärderingar av dess effekter på beteendeförändringar. Utbildning om HIV/AIDS kräver en sammanhållen ansats som inkluderar formella, icke-formella och informella sektorer. Lärarnas roll är avgörande. Införandet av utbildning om HIV/AIDS i läroplanen behöver därför kompletteras med en vidareutbildning av lärare, Global Monitoring Report, 2008, för att lärarna skall kunna röra sig bortom ett strikt vetenskapligt och selektivt sätt att undervisa och istället använda en mer förankrad ansats som anknyter ämnet till elevernas lokala miljö.

Utbildning kan också beskrivas som ett ”socialt vaccin” som kan ge barn de kunskap, attityder och färdigheter som krävs för att göra hälsosamma val om när och hur de har sex samt göra det möjligt att utveckla respekt för sig själva och för andra.

I Zambia har HIV/AIDS epidemin varit känd sedan tidigt 1980-tal med en topp i antal nya fall i början på 1990-talet. Medan smittspridningen varit ganska stabil sedan dess har proportionellt större antal av särskilt av unga kvinnor drabbats.

Hos befolkningen är kunskapen om hur HIV/AIDS överförs, liksom hur det förebyggs, till stor del karaktäriserad av missuppfattningar. Enligt Zambias National AIDS Commission, NAC (2010) kunde endast 35 procent ange sätt att förebygga smitta av HIV/AIDS. Det faktum att den största andelen av smittade är mellan 25 och 40 år – unga personer i produktiv ålder som utnyttjar sina kun-skaper, färdigheter och möjligheter för individuell och social utveckling – har haft förödande effekter för den sociala välfärden inom familjer och negativa konse-kvenser för Zambias ekonomiska utveckling.

Andelen barn med tillgång till utbildning (närmare 90 procent) och andelen barn som fullföljt sin skolgång har stadigt ökat enligt MOE (2008). Eftersom tillgång till utbildning ökat liksom andelen som fullföljt sin skolgång på grundnivån borde detta innebära att man kan nå majoriteten av den relevanta målgruppen, 7-15 år, med relevant, kvalitativ utbildning om HIV/AIDS. Genom att utnyttja utbildningssystemet för att nå barn och ungdomar med kunskaper om att förebygga HIV/AIDS kan den konstaterade informationsklyftan överbryggas.

Den nya läroplanen (MOE, 2002, 2003) och kursplaner rörande HIV/AIDS (MOE, 2003) har visat på de kulturella barriärer och hinder som


finns för att genomföra undervisning om HIV/AIDS. Traditionella vanor och ritualer som sexuell rensning, initiationsriter och tatueringar samt de tabun och stigman som förknippas med att tala om HIV/AIDS och sex offentligt behandlas för första gången i det formella skolsystemet.

Kontextuella begrepp

Den kontextuella begreppsapparaten utvecklades för att undersöka och förstå de processer pågår mellan globala och lokala dimensioner vid utvecklingen av utbildningsprogram för att förebygga HIV/AIDS i som en zambisk kontext. Denna begreppsapparat bygger på en holistisk, bio-ekologisk utvecklingsmodell en ansats som innefattar strukturella, kulturella och konstruktivistiska paradigm. Ett tolkande perspektiv och Engeströms (1987) tredje generation av kulturell-historisk aktivitetsteori (CHAT), som inbegriper inkluderande expansivt lärande, användes som verktyg för att identifiera, analysera och förstå hur utbildnings-strategierna för att förebygga HIV/AIDS utvecklades, implementerades och uppfattades av de mångfaldiga lokala intressenterna i den södra provinsen. Ansatsen med ett flernivåperspektiv visar klart den dubbla relationen mellan influenser på makro- och mikronivån på strategier för att förebygga HIV/AIDS.

Att förstå dynamiken i hur samhällen fungerar, länken mellan kultur och världsbild, hjärnans mjukvara, är avgörande. I det afrikanska samhälle som studeras, har begreppet ubuntu identifierats som ett nyckeltema som samman-länkar, även om riskerna som följer med möjlig polarisation kan noteras som alternativa begrepp om lärande och kommunikation. Vygotskys medlarbegrepp undersöks i detalj och dess relation till formell utbildning utvecklas.

Den kontextuella begreppsapparaten för studien i dess helhet är därför fast förankrad i ett batteri av relaterade teoretiska begrepp som bidrar till att belysa den djupare dynamiken bakom förändringar och potentiella hinder inom ett samhälle som Zambia.

Metod

Den utbildning som utvecklats för att förebygga HIV/AIDS som granskas i föreliggande studie användes i alla elva distrikt i provinsen, omfattande ungefär 890 grundskolor. Forskarens dubbla roller, underlätta projektet och bedriva forskning, hade fördelen av tillgång till intervjupersoner och information på olika nivåer. Studien genomfördes med tillstånd av provinsens utbildningsdirektör, även om den mesta av datainsamlingen skedde genom en öppen forsknings-ansats.

Studiens ansats med flera nivåer krävde användningen av ett brett spektrum av metodologiska strategier som fältanteckningar, strukturerade och öppna enkäter, intervjuer, analyser av dokument och relevanta protokoll. En kvalitativ och konstruktivistisk grundad teori, grounded theory som forskningsmetod

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användes som ett komplement genom respondenternas aktiva deltagande i olika projektaktiviteter.

Det konstruktivistiskt grundade paradigment kompletterades med CHAT. Ett datorstött program för kvalitativa analyser, NVivo, användes för att struk-turera och koda samt konstruera de kärnkategorier som identifierats i den stora datamängden. Medan CHAT fokuserar på kultur och historia, fokuserar den konstruktivistiskt grundade teorin på handlingar av individuella grupper – ett angreppssätt som enligt Seaman, ytterligare utvidgar den pågående utvecklingen av grundad teori. De kriterier som utvecklats i studien utvecklades kontinuerligt. Ansatsen i flera nivåer som inbegriper deltagande motsvarar Smiths begrepp om avkoloniserad metoder genom erkännandet av olika världsuppfattningar och epistemologiska synsätt.

Orsakerna bakom spridningen av HIV/AIDS

Nyckeln till att förstå spridningen av HIV/AIDS är att förstå vilka faktorer som orsakar spridningen. Det vanligaste sättet för spridning av HIV/AIDS i Zambia är via heterosexuellt sex, vilket svarar för 80 procent av alla infektioner. Detta förvärras ytterligare genom högriskbeteenden, socio-ekonomisk ojämlikhet och den höga förekomsten av obehandlade sexuellt överförda infektioner. De strukturella och kulturella drivkrafterna bakom spridningen av HIV/AIDS i Zambia, till viss del överlappande, är relaterade till kvinnors underordning, inkluderande begränsningar av flickors och kvinnors möjligheter att förhandla om sex och deras kringskurna makt att neka sex till makar, släktingar och andra. Detta förstärks ytterligare genom bristande skydd i lagar och sedvanerätt. Den låga socio-ekonomiska statusen för kvinnor och flickor, särskilt änkor och föräldralösa, tvingar dem till prostitution, vilket ytterligare ökar deras risk-faktorer.

Utöver de faktorer som nämnts ovan har MOE (2004a) också identifierat kulturella ritualer och traditioner som riskfaktorer för att smittas av HIV. MOE konstaterar att månggifte, rituell rening, traditionell medicin, torr sex, arv av land och sedvanerätt ofta resulterar i omständigheter som ökar sannolikheten för spridning av HIV. Enligt traditionen är det tabu att diskutera sexuella frågor med någon från det motsatta könet. Folk talar sällan om HIV, även med sina egna barn. Den vanligaste orsaken angavs vara att de inte var bekväma med att tala om det, att ”öppna upp” skulle i de flesta fall medförda stigmatisering.

Studien visar hur de kulturella drivkrafterna och missuppfattning om spridning och förebyggande av HIV belyser behovet av att inkludera de lokala ledarna för att utveckla en ansats anpassad till lokalsamhället. Ett nära samarbete mellan medlemmarna i lokalsamhället, inklusive föräldrar och lokala skolor, är något som också lyfts fram i MOE:s läroplaner (MOE, 2003) som ett sätt att anpassa strategin för begränsning av HIV/AIDS till den lokala nivån.


De traditionella ledarnas roll

De lokala ledarna i Zambia, också kallade hövdingar chiefs, har en formell roll i utvecklingen av sina hövdinga- eller kungadömen. De ansvarar för kultur och tradition och deras roll är reglerad i nationell lag genom Hövdingahuset (House of Chiefs). Hövdingdömena varierar stort i omfattning och har sina egna karakteristika, strukturer och utvecklingsprioriteringar beroende på läge och historisk utveckling.

I studien var vissa hövdingar rädda för att gå emot traditionella praktiker. De mest inflytelserika hövdingarna med säte i Hövdingahuset, var däremot mycket oroade över HIV/AIDS och dess negativa effekter för deras hövdingadömen. De var direkt involverade i interventionen från första början som dörröppnare gate openers med ett utvecklingsperspektiv. De använde ny kunskap om hur HIV kan förebyggas för att förbättra villkoren för byborna och sitt hövdingadöme. Vikten av att förhindra HIV/AIDS framhölls trots att detta kunde innebära omvandlingar och förändring av traditionella vanor, riter och praktiker.

Hövdingarna bekämpade epidemin på olika sätt, men deras strategier kategoriserades under paraplyet socialt vaccin. Deras agerande kan sammanfattas som interventioner inom deras hövdingadömen och inom Hövdingahusets struktur. Hövdingarna samarbetade med parter från två olika aktivitetsområden, dvs. skolområdet, bestående av institutioner och aktörer inom MOE och det traditionella lokalsamhället, inkluderande traditionella ledare, parlamentet och lokala parlamentsledamöter samt huvudmän. Hövdingarnas agerande som legitima ledare och rollmodeller hade stor påverkan vad gäller deras olika begränsningsinterventioner.

HIV/AIDS prevention före projektets insatser

Innan de utbildningsinsatser mot spridning av HIV/AIDS införts, som är i fokus i denna studie införts, fanns det ett antal icke-formella initiativ inriktade mot olika sektorer och nivåer i Zambia drivna av olika icke-statliga eller trosinriktade organisationer. Den globala UNAIDS strategin och den nationella MOE:s HIV/AIDS strategin initierades båda år 2002 och genomfördes via nationella strukturer och överenskommelser. UNAIDS program hade en mångsektoriell och tvärministeriell ansats som inkluderade utbildning för att förebygga HIV/AIDS. MOE:s strategi utgjorde en central komponent inom investerings-planen för grundläggande utbildning, Basic Education Sub-Sector Investment Plan (BESSIP), ett program finansierat av flera givare för att stödja Zambia.

Bristen på samordning och en helhetssyn mellan NAC och MOE:s strategi för förebyggande av HIV/AIDS på nationell nivå, kombinerat med MOE:s frånvaro i processer och initiativ drivna av NAC, skapade en komplicerad och icke sammanhållen genomförandestrategi vad gäller införandet av utbildningen för att förebygga HIV/AIDS. Bristen på information och deltagande från

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centralt och lokalt håll identifierades som ett stort hinder enligt MOE:s regler och rutiner, eller för att använda Engeströms terminologi en primär motsättning.

De undersökningar som genomförde i projektets utgångsläge visade att de berörda, inklusive tjänstemän från MOE från distriktsnivå ner till skolnivån, var okunniga om existerade policy och strategier för att förebyggande HIV/AIDS genom utbildningsinsatser som stöddes i dessa nationella program. De insåg vikten av att tillfoga HIV/AIDS förebyggande utbildning som en del av läroplanen, men visste inte hur man skulle bedriva den undervisningen. De saknade information, hade inte tillfrågats eller fått någon egen utbildning i frågan.

Resultaten från intervjuer med rektorer vid projektstarten liksom skol- och klusterbesök belyste hur de betraktade de socio-kulturella och kontextuella villkoren som pådrivare av smittan. Ett stort hinder var det tabu som gällde öppna samtal om HIV/AIDS och hur det hängde samman med sex. Enligt dessa berörda skulle att bryta mot detta tabu leda till stigmatisering. MOE:s direktiv underströk vikten av att tala om sex i skolundervisningen samtidigt som rektorer och andra skolaktörer var förhindrade av det p. g. a. kulturella tabun– ytterligare en betydande motsättning i relation till ett effektivt förebyggande av HIV/AIDS. Det varierade landskapet, med skillnader i miljö och levnadsförutsättningar mellan varje lokalsamhälle, belyser hur praxis och kontext varierar liksom hur diskussionen om vad som driver epidemin återspeglar behovet av lokalt förankrade strategier för förebyggande som är relevanta för eleverna.

Projektets inledande studie visar tydligt hur de olika meso- exo- och mikro-nivåernas aktörer uppfattade MOE:s initiativ rörande bekämpning av HIV/AIDS belyser hur makrofrågor påverkade genomförandet av planerade policy och strategier på gräsrotsnivån (dvs. skola och lokalsamhälle).

Flera röster i planeringen och förhandlingar om insatser

Studien visar på kraften av deltagande och horisontell integrering av de berörda i hanteringenav de utmaningar som HIV/AIDS innebär, genom en inkluderande planeringsprocesser som ledde fram till lokalt anpassade initiativ. Hövdingarna, som varande de andliga ledarna, agerade som den signifikante andre, som Weertch and deras bidrag visade sig vara ett viktigt förmedlande verktyg (Cole, 1996) i den förebyggande ansats mot HIV/AIDS som analyseras i denna studie. Som rollmodeller och gate openers bröt de offentligt mot kulturella tabun. Genom att dela med sig sina idéer om att de traditionella, men riskabla beteenden var möjliga pådrivare av epidemin, tog de ledningen i en öppen diskussion av förändringar för att förebygga HIV/AIDS och vikten av att vårda de smittade – ett centralt tema i HIV/AIDS programmet.

Den existerande världsuppfattningen, kulturella normer och traditionerna, som kan karakteriseras som sekundära artefakter, inklusive tabun och stigma-tiseringen av dem som bröt mot dessa, ansågs vara de viktigaste begränsande faktorerna i arbetet mot HIV/AIDS. Där hövdingarna tog en aktiv del i att verka


för kulturella förändringar var deras medverkan av avgörande betydelse eftersom detta legitimerade deltagandet av byborna, inklusive lärare och elever, i arbetet mot HIV/AIDS.

Genom att ifrågasätta initiationsriter, riter som innebar risk för ungdomarna att smittas av sjukdomen, och uppmana föräldrar att diskutera HIV/AIDS med sina barn, åstadkom hövdingarna att dessa riter förändrades eller avskaffades. Eftersom föräldrarna deltog i arbetet mot HIV/AIDS blev de mer informerade och fick tillstånd av de traditionella ledarna att ta ansvar för barnens utveckling och uppfostran, etablerades nya kulturella mönster. Gyeke (1996) hävdar att förändring av kulturella mönster sker över tid, men det första steget är för en generation att ifrågasätta värdet av traditioner och praxis. Det är exakt vad deltagarna i denna studie gjorde. Bidragen från olika intressenter, inklusive elever, visar på kraften av ett brett engagemang från berörda och ett horisontellt lärande.

Kulturella och traditionella protokoll och normer respekterades i dessa processer baserade på deltagande och åsikter från de olika aktörerna. Detta återspeglar deras epistemologiska synsätt när det handlar om att förhandla och komma överens om en gemensam vision för de nya målen för deras aktiviteter. Genom detta blev de engagerade i ett horisontellt samarbete tvärs över tradi-tionella gränser och verksamhetsområden, vilket bidrog till överskridande av kulturella gränser och skapandet av nya innovativa praktiker och förändring av utbildningen.

Genom att underlätta för deltagarna kunde dessa delta i att i samarbete ”ge röst och namn på sin värld”, i termer av ”här och nu” eller utifrån deras nuvarande, existentiella och konkreta situation (Freire, 1972). En sådan process bidrar till ett aktivt medvetet engagemang, som förändrar både världen och den agerande individen i en frigörande riktning. (Chambers & Petit, 2003, Freire 1972). Den inkluderande och deltagande processen belyser ytterligare vad Smith (2007) beskriver som en avkolonialiserande ansats, som gjorde det möjligt för deltagarna att ta in andras perspektiv.

De synpunkter och den kunskap som presenterades av de olika deltagarna (t.ex. traditionella ledare, MOE anställda, icke-statliga organisationer, elever, lärare, föräldrar, professionella och nybörjare) under de inledande mötena skapade en lärandesituation där traditionell kunskap och praxis utmanades och ifrågasattes inom ramen för ny kunskap om HIV/AIDS, dess drivkrafter och strategier för att motverka det, utbildningspolicy och praktik. Denna lärande-process illustrerar första steget i ett expansivt lärande enligt Engeströms termi-nologi.

Deltagarna ifrågasatte existerande åtgärder avseende spridning och förebyggandet av HIV/AIDS. De identifierade primära och sekundära motsätt-ningar baserat på kunskapsutbyten, diskussioner och förhandlingar. De utvecklade nya idéer, en modell för en ny lösning för att bekämpa epidemin i sina egna distrikt och de utvecklade ett nytt mål för sin verksamhet.

Ett samordningsteam för HIV/AIDS etablerades för att säkerställa sam-arbetet mellan representanterna från de två samhällssektorerna, skolsystemet och

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det traditionella samhället. Teamet bestod av tre MOE-anställda – en som representant för provinsen, en från distriktet och en rektor från skolan- som skulle arbeta nära en extern expert, som hade den dubbla rollern som visstids konsult och forskare. Den skol- och lokalsamhälledrivna ansatsen riktade in sig på lärare, elever, föräldrar och bybor. Den inkluderade såväl traditionella ledare som andra samhälleliga ledare, anställda inom utbildningsväsendet, icke statliga organisationer, kyrkor och hälsokliniker, när detta var relevant. Representanterna för olika institutioner och organisationer var vana vid att minska effekterna och spridningen av HIV/AIDS genom förebyggande åtgärder.

År 2006 användes denna ansats i alla distrikt i den utsedda provinsen. De vägledande principerna var rotade i ett deltagande och situationsförankrat synsätt, som återspeglade lokal kontext och behov. Som Collins (1998) hävdar är dessa processer frigörande och nära relaterade. Smith karaktäriserade ansatserna som avkolonisering med befolkningen som en erkänd part i sin egen utveckling. Till detta kommer, utöver principen om olika intressegruppers involvering, nätverksbyggande, samverkan och koordinering mellan olika yrkesgrupper tvärs över existerande gränser vilket skapade en ny ansats för att förebygga HIV/AIDS i Zambia.

Förändring och omvandling

Baserat på hövdingarnas direkta inblandning i förebyggandet av HIV/AIDS’ spridning inom sina kungadömen kan dessa huvudsakligen beskrivas som inflytelserika gate openers. Inte bara utvecklade de ett antal åtgärder inom sina egna kungadömen utan utövade också inflytande i Hövdingahuset och utförde extern samhällelig marknadsföring om olika projektkomponenter och strategier via TV, radio och tidningar.

Hövdingarna avskaffade inte kultur och tradition, något som varnades för i diskussionen om bekämpande av HIV/AIDS (Gausset, 1997) och inte heller underminerade eller avlägsnade de kulturella skrifter, riter och system. De arbetade hand i hand med sina parlamentsledamöter och fann lösningar på sina problem genom traditionella procedurer inom respektive kungadöme via interna och inhemska processer och strukturer. Genom dessa procedurer nådde de olika kungadömena fram till olika lokala lösningar. Exempel på dessa lösningar är:

� Genom att avskaffa vissa beteenden som var orsaken bakom epidemin (t.ex. sexuell rening, renandet av en änka på onda andar) vände hövdingadömena på reningsriten till en förnyelserit, rening genom att gnugga ryggarna eller örtbad. Dessa nya beteenden reducerade eller eliminerade spridningen av ny smitta.

� Genom ifrågasättande och utmana innehållet i initiationsceremonierna, som förbereder de unga männen för vuxenlivet avskaffade hövdingarna vissa av riterna som utsatte de unga för risken att ådra sig smitta.


� Genom att uppmana föräldrar att diskutera sexualitet och HIV/AIDS med sina barn lyckades hövdingadömena stegvis minska existerande hinder.

På distriktsnivå genomfördes systematisk träning av MOE’s anställda, även rektorer och seniora lärare. MOE:s riktlinjer delades ut och de grupper som tränats från varje skola genomförde sina egna skolbaserade undervisningspass i användandet av en interaktiv metod om HIV/AIDS (MOE, 2003) inom ramen för en planerad tidsåtgång. Femminutersansatsen ersattes så småningom av schemalagd interaktiv förebyggande undervisning om HIV/AIDS, något som allmänt uppskattades av lärare och elever. Genom att använda det lokala språket minskades ojämlik behandling baserad på kön och användningen av diskriminerande begrepp. Förebyggande undervisning om HIV/AIDS genom-fördes både i segregerade och blandade klasser. Informell kamratutbildning och lokalbaserade initiativ utvecklades enligt de villkor och behov som fanns på skolnivån.

PÅ distrikts- och skolnivå återspeglas de olika initiativen de förutsättningar och prioriteringar som råder på båda nivåerna, särskilt på skolnivån fann man egna lösningar inom ramen för det allmänna återkommande HIV/AIDS programmet. Lösningarna baserades på tillgång till resurser, prioriteringar, lokal-tillgång, andra potentiella samarbetspartners samt relationen till och samarbetet med traditionella ledare. Emellertid fanns det aktörer som aktivt bidrog till motståndet mot en smidig utveckling och genomförandet av den nya HIV/AIDS ansatsen. Stöd, där sådant behövdes, följdes upp med nära och kontinuerlig uppföljning och utvärdering av HIV/AIDS programmet på skolnivån något som i många fall skapade en närmare relation mellan skolor och District Education Officer, DEO.

Det faktum att lärare, elever och lokalsamhället lyckades att öppna upp om HIV/AIDS hjälpte också smittade lärare att genomgå test och få tillgång till ARVs genom att stigmatiseringen gradvis minskade. Samma tendenser visade sig bland eleverna, och antalet återgångar till studier bland flickor som fött barn ökade. Liksom fallet var med det traditionella samhället lyckades skolsamhället finna sina egna lösningar relaterade till spridningen av HIV/AIDS.

Väsentliga resultat och bidrag utvecklingsforskning och praktik Studien visar att i stället för att vara fånge i sin kultur, blev deltagarna i den förbyggande utbildningen mot HIV/AIDS styrkta i att använda sin kultur och sitt epistemologiska historiska synsätt för att finna lösningar som förhindra epidemin.

Genom att kombinera CHAT med konstruktivistisk grundad teori i studien kunde de analytiska möjligheterna ökas när det gällde att leda fram till hållbara förklaringar av kulturella och sociala förändringar. Den flermetodiska ansatsen som använts, vilken innebär en rörelse mellan metodologiska traditioner och

Sammanfattning

271

professionella gränser, bidrog till skapandet av ny kunskap och en bredare förståelse för utvecklings- och biståndsarbete.

De huvudsakliga metodologiska angreppssätten kompletterande varandra och medförde synergi vad gäller analysen av de socio-kulturella aktiviteterna som tidigare fått begränsad uppmärksamhet. Utvecklandet av en konstruktivistisk grundad teori baserad på aktiviteter är en kraftfull ansats för forskning som söker större ekologisk validitet eftersom en konstruktivistisk grundad teori om aktiviteter kan utvecklas och användas för analys på olika nivåer och längs olika tidsaxlar beroende intresse. Genom använda denna ansats lyckades forskaren placera sig i en dialektisk relation till data och med en teoretisk utgångspunkt som erbjöd metodologiska riktlinjer och antaganden. Samverkan mellan konstruktivistisk grundad teori och CHAT exemplifieras bäst på det sätt som CHAT tillhandahåller redskap för analys av resultat som kommer fram i konstruktivistiskgrundad teori. Denna komplementaritet genererade nya insikter för aktivitetsbaserad forskning.

References

Aggleton, P. & Parker, R. (2003). HIV and AIDS-related stigma and discrimination: a conceptual framework and implications for action, Social Science & Medicine 57, 13–24.

Arnove, R. & Torres, C. A. (2003). Comparative education: The Dialectic of the Global and the Local (2nd ed.) Rowman & Littlefield Publishers, USA.

Asante, M. K. (2003). Afrocentricity: The theory of social change, Africa American images, Chicago, Illinois, US

Avis, J. (2010). Transformation or transformism: Engeström's version of activity theory. Educational Review, 61(2) 151-165. http://dx.doi.org/10.1080/00131910902844754.

Bakilana, A., Bundy, D., J. & Fredriksen, B. (2005). The Global HIV/AIDS Program.

Bankoff, G. (2001). Rendering the world unsafe: “Vulnerability” a Western discourse. Disasters 25(1): 19-35, http://www.geo.mtu.edu/volcanoes/06upgrade/Social-KateG/Attachments%20Used/Vulnerability.WesternDiscourse.pdf

Barth, F. (2002). An Anthropology of Knowledge. Current Anthropology Vol. 43, No. 1.

Baxen, J. & Breidlid, A. (Eds.) (2009) HIV/AIDS in Sub-Saharan Africa, United Nations University.

Berger, P. L., & Luckmann, T. (1967). The Social Construction of Reality: A Treatise in the Sociology of Knowledmann. New York: Anchor.

Bernstein, B. (2001). Symbolic control: Issues of empirical description of agencies and agents. Social Research methodology, vol. 4, no. 1, 21-33.

Berstein, B. (2010). Vertical and Horizontal Discourse: An essay. British Journal of Sociology of Education, 20:2, 157-173, http://dx.doi.org/10.1080/01425699995380.

Boler, T. (2003). Sound of silence. Difficulties in communicating on HIV/AIDS in schools, Experiences from India and Kenya. ActionAid UK, http://www.actionaid.org.uk/doc_lib/146_1_sound_silence.pdf.

Boler, T., & Jellema, A. (2005). Deadly inertia: A cross-country study of educational responses to HIV/AIDS.

Bray, M., Adamson, B. & Mason, M. (Ed.) (2007). Different Models, Different Emphases, Different Insight in Comparative Education Research, Approaches and Method. Comparative Education Research Centre. The University of Hong Kong, Springer.

Bray, M., Adamson, B., & Mason, M. (Eds.). (2007). Comparative education research: Approaches and methods (Vol. 19). Springer Science & Business Media.

Breidlid, A. (2013). Education, Indigenous Knowledges, and Development in the Global South. Contesting Knowledges for a Sustainable Future. New York. Routledge


Brodryk, J. (2006). Ubuntu, African coping skills. Theory and practice. Paper delivered at CCEAM Conference Conference theme: Recreating Linkages between Theory and Praxis in Educational Leadership 12 – 17 October 2006: Lefkosia (Nicosia) Cyprus.

Bronfenbrenner, U. (1979). The Ecology of Human Development: Experiments by Nature and Design. Harvard University Press. London, England.

Bronfenbrenner, U. (1999). Environments in developmental perspective: theoretical and operational models. In Friedman, S.L. & Wachs, T.D. (Eds.), Measuring environment across the life span: Emerging methods and concepts, (pp 3-28) Washington DC, American Association Press. http://gigusa.org/resources/eg/24.pdf

Bronfenbrenner, U., (Ed.). (2005) Making Human Beings HUMAN. Bioecological Perspectives on Human Development, Sage Publications, London, UK.

Brown, K.M. (1999). Health Belief Model. University of South Florida, Department of Community and Family Health. www.med.usf.edu/~kmbrown/Health_Belief_Model_Overview.htm

Bryant, A. (2003). A Constructiv/ist Response to Glaser. About Barney G. Glaser: constructivist grounded theory? Published in FQS 3 (3). In Forum Qualitative Sozialforschung/Forum: Qualitative Social Research (Vol. 4, No. 1).

Bryman, A. (2008). Social Research Methods, Oxford Univ. Press, New York, USA.

Carm, E. Helland, A.M. & Lexow, J. (1999). The impacts of HIV/AIDS on education, LINS report, Oslo University College, Norway.

Chambers, R. & Pettit, J. (2004). Shifting Power to Make a Difference. In Groves, L. & Hinton, R. (Eds.) Inclusive aid, changing power and relationships in international development, London, Sterling, VA.

Chambers, R. (2008). Revolutions in Development Inquiry, Earthscan, UK. CHANGES (2007). Teacher Survey Report, Zambia, Workshop Background

Paper. Charmaz, K. (2000). Grounded Theory, Objectivist and Constructivist

Methods, In Denzin, N.K. & Lincoln, Y.S. (Eds.) Handbook of Qualitative research, London SAGE.

Charmaz, K. (2003). Strategies of qualitative inquiry. Grounded theory: Objectivist and constructivist methods, 249-291.

Chucks, A. P. (2008). The effects of HIV/AIDS pandemic on agricultural production as perceived by farmers in the central agricultural zone of Delta State, Nigeria. Middle East Journal of Scientific Research, 3(2), 90-95.

Claarke, R. L. (2008). Chapter Three, Pholosophy or Theory? In Odhiambo, O., Burton, R. and Brandon, E. (2008) Conversations in Philosophy: Crossing the Boundaries, Cambridge Scholars Publishing, UK.

Cole, M (1996). Cultural Psychology, London: Harvard University Press. Cole, M., & Engeström, Y. (1993). A cultural historic approach to distributed

cognition. Distributed cognitions, pp. 1-46.

References

275

Collins, C. (2011). Reflections on CHAT and Freire's Participatory Action Research from the West of Scotland: Praxis, Politics, and the “Struggle for Meaningful Life”, Mind, Culture, and Activity, 18(2) 98-114 http://dx.doi.org/10.1080/10749039.2010.484098

Common Wealth Secretariat, (CS) (2008) Zambia - History, http://www.thecommonwealth.org/YearbookInternal/139669/society/

Communication for Social Change (CFSC). http://www.communicationforsocialchange.org. Retrieved: 040208

Constitution of Zambia. (1996). Part XIII, Chiefs and House of Chiefs (As amended by Act No. 18 of 1996) http://www.thezambian.com/Constitution/1996partxiii.aspx

Contu, A. & Willmott, H. (2003). The importance of power relations in Learning Theory, Oganization Science, 14 (3) (pp. 283-296)/

Coombe, C. & Kelly, M.J. (2001). Treds/Cases Education as a vehicle for combating HIV/AIDS Prospects, vol. XXXI, no. 3, September 2001 http://www.researchgate.net/profile/Carol_Coombe/publication/228693138_Education_as_a_Vehicle_for_Combating_HIVAIDS/links/0a85e52e13a52362ab000000.pdf

Creswell, J. W. (2009). Research Design: Qualitative and Quantitative Mixed Methods Approaches. London, Sage Publication

Daniels, H. (2012). Institutional culture, social interaction and learning, Learning, Culture and Social Interaction, 1 (1). Pp. 2-11. http://dx.doi.org/10.1016/j.Icsi.2012.02.001

Darnell, F. & Hoem, A. (1996). Taken to extremes: Education in the far North, Aschehaug AS, Oslo, Norway.

Das, J., Dercon, S., Habyarimana, J. & Krishnan, P (2005) Teacher Shocks and Student Learning: Evidence from Zambia. World Bank Policy Research Working Paper, (3602).

Daun, H., & Mundy, K. (2011). Educational Governance and Participation–With Focus on Developing Countries. Institute of International Education, Stockholm University.

Dei, G. J. S. (2002). Spiritual knowing and transformative learning. In Expanding the boundaries of transformative learning (pp. 121-133). Palgrave Macmillan US.

Dobbin, F. (1994) Cultural models of organization: The social construction of rational organizing principles. In Crane, D. (DATE), The Sociology of Culture: Emerging Theoretical Perspectives. Oxford: Basil Blackwell. www.wjh. harvard.edu/~dobbin/cv/book_chapters/1994_CultModOrg_Crane.pdf.

Duflo, E. Dupas, P. Kremer, M. & Sinei, S (2006). Education and HIV/AIDS Prevention: Evidence from a randomized evaluation in Western Kenya, World Bank Policy Research Working Paper 4024, October 2006. https://wdronline.worldbank.com/bitstream/handle/10986/9090/WPS4024_WDR2007_0004.pdf?sequence=1

Easterly, W. (2006). The white man’s burden, Penguin Books, Ltd, England.


Elliott, R., Fischer, C. T., & Rennie, D. L. (1999). Evolving guidelines for publication of qualitative research studies in psychology and related fields. British Journal of Clinical Psychology, 38(3), 215-229

Ellis, V., Edwards, A., & Smagorinsky, P. (Eds.). (2010). Cultural-historical perspectives on teacher education and development: Learning teaching. Routledge.

Engeström, R. et al. (2014) A draft of reflections on Change Laboratory: towards a dynamic interplay of global and local forces in designing change in education. Pending permission

Engeström, Y (2008b). The Future of Activity Theory: A Rough Draft. Keynote lecture presented at the ISCAR Conference in San Diego, Sept. 8-13, 2008.

Engeström, Y. (1987). Learning by expanding. Helsinki: Orienta-Konsultit Oy. Engeström, Y. (2001a). Expansive learning at Work: Toward an activity

theoretical reconceptualization, Journal of Education at Work, 14:1, 133-156. Http://dx.doi.org/10.1080/13639080020028747

Engeström, Y. (2001b).The Horizontal Dimension of Expansive Learning: Weaving a Texture of Cognitive Trails in the terrain of Health Care in Helsinki, Paper presented at the international symposium ‘New Challenges to Research on Learning’, March 21-23, University of Helsinki, Finland. www.google.no/search?q=THE+HORIZONTAL+DIMENSION+OF+EXPANSIVE+LEARNING%3A+WEAVING+A+TEXTURE+OF+COGNITIVE+TRAILS+IN+THE+TERRAIN+OF+HEALTH+CARE+IN+HELSINKI&rls=com.microsoft:no:IE-SearchBox&ie=UTF-8&oe=UTF-8&sourceid=ie7&rlz=1I7SUNC_noNO365

Engeström, Y. (2004). New forms of learning in co-configuration work. Journal of Workplace Learning, 16(1/2), 11-21.

Engeström, Y. (2008a). From teams to knots: Activity theoretical studies of collaboration and learning at work. Cambridge: Cambridge University Press.

Engeström, Y. and Sannino, A. (2010). Studies of expansive learning, Foundation, findings and future challenges, Educational Research Review, vol- 5, 1-24

Engeström, Y., Miettinen, R., & Punamäki, R. L. (Eds.). (1999). Perspectives on activity theory. Cambridge University Press.

FAO Corporate Document Repository (1998). Zambia country paper Wetland classification for agricultural development in Eastern and Southern Africa: The Zambian case, http://www.fao.org/docrep/003/X6611E/x6611e02f.htm

Fatnowna, S. & Pickett, H. (2002). The place of Indigenous Knowledge Systems in the Post-Postmodern Integrative Paradigm Shift, In Hoppers, C. A. O. (Eds.) (2002). Indigenous Knowledge and the Integration of Knowledge Systems. Towards a Philosophy of Articulation, New Africa Books, Ltd. South Africa.

Ferrara, V. J. (2001). Prolegomena to an African Western Ethics and Theory of Rights in Idehuru, Obioma, Contending Issues in African Development. Advances, Challenges and the Future, Greenwood Press, US.

References

277

Findings (2005).What do we do with culture? Engaging culture in development, Findings, 2005, vol. 3 Exchange, a networking and learning programme on health communication for development http://www.healthcomms.org/resource/index.html. (Retrieved 031008)

Freire, P. (2000). Pedagogy of the oppressed. Bloomsbury Publishing. Fylkesnes, K., & Siziya, S. (2004). A randomized trial on acceptability

of voluntary HIV counselling and testing. Tropical Medicine & International Health, 9(5), 566-572.

Fylksnes, K. Ndhlovu, Z., Kasumba, K., Musonda, R. M. & Sichone, M. (1998). Studying dynamics of the HIV epidemic: population-based data compared with sentinel surveillance in Zambi, AIDS, 12:1227–1234 http://www.researchgate.net/profile/Knut_Fylkesnes/publication/13608232_Studying_dynamics_of_the_HIV_epidemic_population-based_data_compared_with_sentinel_surveillance_in_Zambia/links/0fcfd5093c345bbc25000000.pdf

Gausset, Q. (2001). AIDS and cultural practices in Africa: the case of the Tonga (Zambia) Social Science and Medicine 52 (2001) 509-518 http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6VBF-41WBHRS-2&_user=2195977&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000035218&_version=1&_urlVersion=0&_userid=2195977&md5=c59259eae20092a86fd221568595afc9

Gershom, M. (1997). Traditional Leadership and Democracy in Zambia, National Workshop for Zambian Chiefs on the role of Traditional Rulers in Promoting Democracy, April-June 1997.Zambia.Konrad Adenauer Stiftung.

Giddens, A., & Hutton, W. (2000). On the edge: Living with global capitalism. Jonathan Cape.

Global Campaign for Education, (2005) Deadly Inertia: A cross-country study of educational responses to HIV/AIDS, http://www.campaignforeducation.org (retrieved 120206)

Global Monitoring report (2010) UNAIDS Report on the Global Aids Epidemic, Joint United Nations Programme on HIV/AIDS (UNAIDS)

Goduka, I. N. (2000). African/Indigenous Philosophies: Legitimizing Spiritually Centered Wisdoms within the Academy, in Higgs, P. et al (Eds.) (2000) African Voices in Education, The Rustica Press, Western Cape.

Goffman, E. (1963). Stigma. Notes on the management of spoiled identity. New York: Simon & Schuster.

GTZ (2004). Chieftaincies of Zambias. NORAD, Report. Gyekye, K. (1997). Traditions and modernity: Philosophical reflections on the African

experience. Oxford University Press.


Hatt, D. (2004). Unpacking the Concept of Traditional Authority: Do differences between elders, Headmen, Chiefs and Kong matter in Social and Economic Development? In Chieftain: the Journal of Traditional Governance Chieftain, Volume 1, 2004- ?https://dspace,ucalgary.ca/handle/1880/335

Hofstede, G. (1991). Cultures and Organizations. Intercultural Cooperation and its Importance for Survival. MCgraw-Hill International, (UK)

Human Rights Watch. (2003) Suffering in silence: The Links between Human Rights Abuses and HIV, Transmission to Girls in Zambia, New York, Washington, London http://www.hrw.org/reports/2003/zambia/zambia1202.pdf.

Huntington, S. (2000). Cultures Count, in L. E. Harrison, & S. Huntington, (Eds.). Culture Matters, How values shape Human progress. Basic Books, New York, NY.

IIRR, (1996). Recording and using indigenous knowledge: A manual. Philippines, Implementing the Fifth National Development Plan. http://collections.infocollections.org/ukedu/en/d/Jii03re/

Infoplease, (2008). http://www.infoplease.com/ipa/A0108165.html. Inglehart, R. (2000): Culture and democracy, In Harrison, L. E., & Huntington,

S. (Eds.). Culture Matters, How Values Shape Human progress. Basic Boks, New York, NY

Inglehart, R., & Welzel, C. (2005). Modernization, cultural change, and democracy: The human development sequence. Cambridge University Press.

Integrated Regional Information Networks (IRIN) (2006). Progress Report. http://www.unocha.org/ochain/2006/chap5_1.htm.

International Development Research Centre (IDRC) Canada, http://www.idrc.ca/EN/Resources/Publications/Pages/ArticleDetails.aspx?PublicationID=761#aaa, n.d.

International Development Research Centre (IDRC). Learning lessons from traditional leaders in Ghana http://www.idrc.ca/EN/Resources/Publications/Pages/ArticleDetails.aspx?PublicationID=761#aaa, n.d.

Kasungula District Education Board. (2005) Bridge of Life. Issue No.1-January 2005. District Newsletter.

Kazembe L. M. (2204?). Traditional Leaders Initiative End of Program Report, RH & HIV/AIDS Consultant; Zambia Integrated Health. https://www.google.com/?gws_rd=ssl#q=Traditional+Leaders+Initiative+End+of+Program+Report

Kelly, M, J. (2008). Education for an Africa without AIDS. Nairobi, Paulines Publications Africa.

Kelly, M. J. (2000). Planning for Education in the Context of HIV/AIDS. Unesco, International Institute for Educational Planning.

Kelly, M. J. (2000). Standing Education on its Head: Aspects of Schooling in a World with HIV/AIDS. Current issues in comparative education, 3(1), 28-38.

References

279

Kelly, M. J. (2004). Responding to the Challenges of HIV/AIDS Presentation to SIDA HIV/AIDS Focal Point Seminar Lusaka

Kelly, M. J. (2010). HIV and AIDS; A Social Justice Perspective. Nairobi, Paulines Publications Africa.

Klees, S. J. (2008). Presidential Address: Reflections on Theory, Method, and Practice in Comparative and International Education, CIES newsletter, number 147, http://cies.us/newsletter/may08/index_may08.htm

Kvale, S., & Brinkmann, S. (2009). Interviews: Learning the craft of qualitative research interviewing. Sage.

Law, N. (2000). Case study methodology in Bray et. al. Comparing Pedagogical Innovations

Ledwith, M. (2001). Community work as critical pedagogy: re-envisioning Freire and Gramsci, Community Development Journal, Vol 36. No.3: pp171-182

Ledwith, M., & Asgill, P. (2000). Critical alliance: Black and white women working together for social justice. Community Development Journal, 35(3), 290-299.

Lerner, R. M. (2005). Foreward in U. Bronfenbrenner Career contributions of the consummate developmental scientist. Making human beings human: Bioecological perspectives on human development, x-xxvi.

Lessem, R., & Nussbaum, B. (1996). Sawubona Africa: Embracing four worlds in South African management. Zebra Press.

Lincoln. Y. S. (1985). Naturalistic inquiry (Vol. 75). Egon G. Guba (Ed.). Sage. Mäkitalo, Å. (2012). Professional learning and the materiality of social practice,

Journal of Education and Work, Vol.25, No.1, February 2012, 59-78. Malambo, R. M. (2000). Teach Them While They Are Young, They Will Live to

Remember The views of teachers and pupils on the teaching of HIV/AIDS in basic education: A case study of Zambia’s Lusaka and Southern Provinces, Current Issues in Comparative Education, 3(1).

Manzon, M. (2007). Comparing Places in Bray, Mark, Adamson, B. and Mason, M (Ed.) (2007) Comparative Education Research, Approaches and Methods, Comparative Education Research Centre The University of Hong Kong, Springer.

McKee, N., Bertrand, J., Becker-Benton, A., & Becker, B. L. (2004). Strategic communication in the HIV/AIDS epidemic. Sage Publications, London.

McLaren, P., & Kincheloe, J. L. (Eds.). (2007). Critical pedagogy: Where are we now? (Vol. 299). Peter Lang.

Merson, M. H. (2006). The HIV–AIDS Pandemic at 25 — The Global Response http://content.nejm.org/cgi/reprint/354/23/2414.pdf (retrieved 220208)

Meyer, J. W., Boli, J., Thomas, G. M., & Ramirez, F. O. (1997). World society and the nation-state. American Journal of sociology, 103(1), 144-181

Michelo, C. & Sandøy, I.F. & Fylkesnes, K (2006). Marked HIV prevalence declines in higher educated young people: evidence from population-based surveys (1995–2003) in Zambia, AIDS 20 (7)


Mills, J. B, A & Francis, K. (2006). Constructivist methodology. The Development of Constructivist Grounded Theory, International Journal of Qualitative Methods 5 (1).

Ministry of Education, (2004a). HIV/AIDS Peer Education Training of Trainers Information. Zambia

Ministry of Education, Science, Vocational Training and Early Education (MESVTEE). (2014). Education for All 2015 National Review, http://unesdoc.unesco.org/images/0023/002315/231573e.pdf#page40

Ministry of Education. (1996) Educating Our Future. National Policy on Education.

Ministry of Education. (2000) Strategic Framework 2001-2003. National HIV/AIDS/STD/TB Council, October.

Ministry of Education. (2000a). Recent Developments in the Fight against HIV/AIDS in the Ministry of Education in Zambia

Ministry of Education. (2001). HIV/AIDS Education Programme – BESSIP (2001–2006)

Ministry of Education. (2001a). HIV/AIDS Education Strategic Plan, Zambia, 2001–2005.

Ministry of Education. (2002a). HIV/AIDS Education Component Logical Framework, August.

Ministry of Education. (2002b). Strategic Plan 2003-2007, July draft. Ministry of Education. (2002c). HIV/AIDS programme. Training and Recourse

Manual for Education Staff, Zambia Ministry of Education. (2003) Impact assessment of HIV/AIDS

on the education sector. Ministry of Education. (2003a) Monitoring and Evaluation Framework.

Directorate of Planning and Information, June. Ministry of Education. (2003b). Interactive Methodologies. Manual for HIV/AIDS

Prevention in Zambian Schools, 1st edition. Ministry of Education. (2003c). Improving Access and Quality Education

in Basic Schools. Training Manual for Trainers in the Basic Education School Curriculum. Directorate of standards and Curriculum.

Ministry of Education. (2004). Education Sector programme, National Annual work-plan and budget, Republic of Zambia.

Ministry of Education. (2004a). National HIV/AIDS Monitoring and Evaluation Framework, May draft. http://hivaidsclearinghouse.unesco.org/ ev_en.php?ID=1185_201&ID2=DO_TOPIC

Ministry of Education. (2004b). School Special Issues Annual Workplan Guidelines. A guide for Head Teachers

Ministry of Education. (2005). 5th National Development Plan, Education Chapter 22. Preliminary Draft, 11Sept.

Ministry of Education. (2005a). Principles of Education Boards Governance and management manual, Education Board Services, Lusaka, Aug.

References

281

Ministry of Education. (2006). Educational Statistical Bulletin Prepared by: Directorate of Planning and Information

Ministry of Education. (2007). Education Sector National Implementation Framework 2008 – 2010.

Ministry of Education. (2008). Teaching in the Window of Hope, HIV/AIDS Education for Zambian Teachers, Tutors guide Draft, Community Health and Nutrition, Gender and Education Support (MOE/Changes2)

Ministry of Health National AIDS Council. (2008). Zambia Country Report. Multi-sectoral AIDS Response Monitoring and Evaluation Biennial Report 2006-2007, Submitted to The United Nations General Assembly Special Session on AIDS (Traditional Leaders on the Frontline 12. Addressing Harmful Cultural Practices to Reduce Gender-based Violence and HIV in Southern Africa p.13. (Scorgie, 2002)

Mukute, M and Lotz-Sisitka, H, (2012). Working with Cultural Historical Activity Theory and critical realism to investigate and Expand farmer learning in Southern Africa, in Mind Culture and Activity, 19:4, 342-367, http://www.tandfonline.com/loi/hmca20.

Mulaudzi, F.M. (2007). Comments on the XIV International HIV/AIDS Conference: An ‘Ubuntu’ Perspective, Religion and Theology 14 105-115 http://www.brill.nl/rr.

Musonda, G. (1997). Traditional Leadership and Democracy in Zambia, National Workshop for Zambian Chiefs on the role of Traditional Rulers in Promoting Democracy, April-June 1997. Zambia Independent Monitoring team and Konrad Adenauer Stiftung.

Musonda, L. (2003) From donors to ‘cooperating partners’: A Change in Nomenclature or Reality. In Development Policy Management Forum (DPMF) Bulletin (Vol. 10, No. 1).

NAC/MOH (2009). Zambia Country Report - National M&E Report to UN General Assembly, Status of the HIV/AIDS Epidemic. National Aids Commission, Zambia

NAC/MOH, (2010). Zambia Country Report, Monitoring the Declaration of Commitment on HIV and AIDS and the Universal Access, Biennial Report, National Aids Commission, Zambia

NAC/MOH. (2008). Zambia Country Report Multi-Sectoral AIDS Response Monitoring and Evaluation Biennial Report 2006-2007. Update Version, Submitted to The United Nations General Assembly Special Session on AIDS. National Aids Commission, Zambia

Ngara, C. (2007). African Ways of Knowing and Pedagogy Revisited, Journal of Contemporary Issues in Education, 2(2), 7-20. University of Alberta http://ejournals.library.ualberta.ca/index.php/JCIE.


Nilsson, P. U. & Jassey, K. (2009) Boosting HIV/AIDS Programming in Civil Society Development cooperation in Sida’s Special Support for NGO Projects Addressing HIV/AIDS 2004–2006 , p67: http://www.sida.se/contentassets/668f3d7fe5eb472eb463972f02f3d2e0/boosting-hivaids-programming-in-civil-society-development-cooperation_1770.pdf

Nyblade, L., Pande, R., Mathur, S., MacQuarrie, K., Kidd, R., Banteyerga, H. & Bond, V. (2003). Disentangling HIV and AIDS stigma in Ethiopia, Tanzania and Zambia. www.icrw.org/docs/stigmareport093003.pdf

Nyblade, L., Pande, R., Mathur, S., MacQuarrie, K., Kidd, R., Banteyerga, H. & Bond, V. (2003). Disentangling HIV and AIDS stigma in Ethiopia, Tanzania and Zambia.

Owuor, A J. (2007). Integrating African Indigenous Knowledge in Kenya’s Formal Education System: The Potential for Sustainable Development. Journal of Contemporary Issues in Education, 2(2), 21-37. University of Alberta, http://ejournals.library.ualberta.ca/index.php/JCIE.

Oxfam. (2004). Renewing our voice, Code of Good Practice for NGOs Responding to HIV/AIDS. Guiding Principles. ( www.oxfam.org.uk/publications,

Pellini, A. (2007). Decentralisation policy in Cambodia: exploring community participation in the education sector. Tampere University Press.

Putzel, J. (2004). The global fight against aids: How adequate are the national commissions? Journal of International Development, 16, 1129-1140.

Ransom, J. S. (1997). Foucault’s discipline: The politics of subjectivity. Duke University Press.

Rasing, T. (2003). HIV/AIDS and sex education among the youth in Zambia: Towards behavioural change. http://hivaidsclearinghouse.unesco.org/ev_en.php?ID=4109_201&ID2=DO_TOPIC.

Ray, D. (2005). Learning Lessons from Traditional Leaders in Ghana IDRC, The international development research centre, Science for humanities, Canada, http://www.idrc.ca/en/ev-82924-201-1-DO_TOPIC.html

Ray, D. (2005). Re-inventing African Chieftaincy in the Age of AIDS, Gender and Development. Volume I. http://dspace.ucalgary.ca/bitstream/1880/43236/1/VOLUME1OVERVIEW.pdf in Traditional Authority Applied Research Network (TAARN). http://dspace.ucalgary.ca/.

Reagan, T., G. (2005). Non-Western Educational Traditions. Mahwah. NJ, USA: Lawrence Erlbaum Associates, Incorporated, Http://site.ebrary.com/lib/sthlmub/Doc?id=10088317&ppg=21

Saasa, O. & Carlsson, J. (2002). Aid and poverty reduction in Zambia. Mission Unaccomplished. The Nordic Africa Institute.

Sachs, J. (2006). The end of poverty: economic possibilities for our time. Penguin. Said, W. E. (1993). Orientalism, Nørhagen paperback, a/s. DK

References

283

Schenker, I. (2006). HIV/AIDS Literacy: An Essential Component in Education for All. EFA Global Monitoring Report. UNESCO. Paris. Background paper. http://www.schoolsandhealth.org/Shared%20Documents/Downloads/HIV%20AIDS%20Literacy%20An%20Essential%20Component%20in%20Education%20for%20All.pdf

Schön, D. (1983). The Reflective Practitioner. How professionals think in Action, Ashgate Publishing Limited, England

Seaman, J. (2008). Adopting a grounded theory approach to cultural-historical research: Conflicting methodologies or complementary methods? International Journal of Qualitative Methods, 7(1), 1-17.

Sen, A. (2006). Identity and Violence, The illusion of destiny, Norton Paperback, US. Serpell, R. (1993). The significance of schooling: Life-journeys in an African society.

Cambridge. Shaeffer, S. (1994). Participation for educational change: a synthesis of experience.

IIEP. UNESCO. Paris Sillitoe, P. (1998). What know natives? Local knowledge in development.

Social Anthropology, 6 (2), 203–220. Smith, L.T. (1999). Decolonizing Methodologies. Research and Indigenous Peoples.

Zed Books Ltd, London & New York. Strauss, A., & Corbin, J. M. (1990). Basics of qualitative research: Grounded theory

procedures and techniques. Sage Publications, Inc. Sydhagen, K. & Cunningham, P. (2007): Human resource Development in

Sub-Saharan Africa. Human Resource Development International, 10(2) 121-135. Taarn (2004) Re-inventing African Chieftaincy in the Age of AIDS, Gender

and Development, https://dspace.ucalgary.ca/handle/1880/43236 TAARN (2004)) Traditional Authority Applied Research Network.

http://people.ucalgary.ca/~taarn/ The Ministry of Education and Research, UFD (2005): Work Plan, 2006

regarding co-operation between The Ministry of Education, Zambia, and the Ministry of Education and Research, UFD, Norway

The Ministry of Education and Research, UFD, (2002) Pilot project on co-operation between The Ministry of Education, Zambia, and the Ministry of Education and Research, UFD, Norway. Report for the year, 2002.

Tikly, L. (2001). Globalisation and Education in the Postcolonial World: towards a conceptual framework, Comparative Education 37(2)151–171 http://education.eastwestcenter.org/education2020/pre-institute%20readings/Tikly.pdf.

Turner, P &Turner, S. (2001) A Web of Contradictions. Interacting with Computers, 14(1), 1-14.

Umemoto, K. (2001). Walking in Another’s Shoes: Epistemological Challenges in Participatory Planning. Journal of Planning Education and Research, 21(1), 17-31.


UN (2010). Global Report United Nations, Millennium Development Goals. http://www.un.org/millenniumgoals/pdf/MDG%20Report%202010%20En%20r15%20-low%20res%2020100615%20-.pdf#page=42.

UNAIDS. (2002). A Conceptual Framework and Basis for Action: HIV/AIDS Stigma and Discrimination. World AIDS Campaign 2002-2003. A Conceptual framework and Basis for Action.

UNAIDS. (2004). Report on the global AIDS epidemic. http://www.unaids.org/bangkok2004/GAR2004_html/GAR2004_00_en.htm, (100305)

UNAIDS. (2006a). Global Facts and figures, http://data.unaids.org/pub/GlobalReport/2006/200605-FS_globalfactsfigures_en.pdf

UNAIDS. (2006b). Fact sheet, progress in Countries. http://data.unaids.org/pub/GlobalReport/2006/200605-FS_Progress-in-countries_en.pdf

UNAIDS. (2006c). UNAIDS in action Zambia: Increasing Editors awareness of HIV and AIDS and Gender http://data.unaids.org/pub/InformationNote/2006/20060730_project_page_zambia_forum_en.pdf

UNAIDS. (2006d). Report on the global AIDS epidemic: Executive summary. A UNAIDS 10th anniversary special edition. http://hivaidsclearinghouse.unesco.org/ev_en.php?ID=6416_201&ID2=DO_TOPIC

UNAIDS. (2007). AIDS epidemic update, December 2007, Joint United Nations Programme on HIV/AIDS (UNAIDS) and World Health Organization (WHO) 2007. http://data.unaids.org/pub/EPISlides/2007/2007_epiupdate_en.pdf

UNAIDS. (2008). Report on the global AIDS epidemic. http://data.unaids.org/pub/GlobalReport/2008/jc1510_2008globalreport_en.pdf (retrieved, 18082010)

UNAIDS. (2010). Global Report, http://www.unaids.org/documents/20101123_GlobalReport_em.pdf.

UNAIDS. (2014). The Gap Report, www.unaids.org/en/resources/campaigns/2014/2014gapreport/gapreport.

UNAIDS. (2016). Fact Sheet. www.unaids.org/sites/default/files/media_asset/UNAIDS_FactSheet_en.pdf

UNDP (2003) Disease, HIV/AIDS and Capacity Implications a case of the Public Education Sector in Zambia Regional Project on HIV and Development, research paper 2.

UNDP (2007). Enhancing household capacity to respond to HIV and AIDS, ZAMBIA. http://www.fanrpan.org./documents/d00247/zambia_HD-Report_2007.pdf.

UNDP (2007a). Human development report, 2007/2008

References

285

UNDP (2010). Human Development Report 2010: The Real Wealth of Nations: Pathways to Human Development.

UNESCO (2006). Teachers and Educational Quality: Monitoring Global Needs for 2015, www.uis.unesco.org/publications/teachers

UNESCO (2006a). HIV & AIDS and Educator Development, Conduct and Support. http://unesdoc.unesco.org/images/0014/001463/146308e.pdf

UNESCO (2006b). HIV & AID Sand Safe, Secure and Supportive Learning. UNESCO (2007). Global Monitoring Report 2008. Education for all by 2015.

Will we make it? UNESCO (2008) Good Policy and Practice in HIV & Aids Education, Booklet 2,

HIV & AIDS and Supportive Learning Environments. http://unesdoc.unesco.org/images/0014/001461/146122E.pdf

UNESCO (2008a). EFA, Global Monitoring Report http://www.unesco.org/education/gmr2008/

UNESCO (2009). EFA Global Monitoring report 2010. Reaching the Marginelized UNESCO (2011). Global Monitoring & Evaluation Framework for Comprehensive

Education responses to HIV and AIDS, Proposed Indicators Draft – January 2011 Prepared by Wendy Heard, international consultant, EduSector AIDS Response Trust, UNESCO.

UNFPA (2003). State of world population, investing in adolescents’ health and rights. http://www.unfpa.org/publications/state-world-population-2003

UNGASS. (2008). Zambia Country Report, Multi-sectoral AIDS Response Monitoring and Evaluation, Biennial Report, 2006-2007, http://data.unaids.org/pub/Report/2008/285ambia_2008_country_progress_report_en.pdf

UNGASS. (2010). Monitoring the Declaration of Commitment on HIV and AIDS and the Universal Access: Biennial Report. (Zambia Country Report) www.unaids.org/sites/default/files/en/dataanalysis/knowyourresponse/countryprogressreports/2010countries/zambia_2010_country_progress_report_en.pdf

UNICEF (2001). Global stigma report, Stigma, HIV/AIDS and prevention of mother-to-child transmission. A pilot study in Zambia, India, Ukraine and Burkina Faso http://www.unicef.org/aids/files/aids_pansoreportBS.pdf

UNICEF (2002) Education, and HIV/AIDS a Window of Hope. www.unicef.org/lifeskills/files/window_of_hope_wb.pdf

United Nations Population Fund (UNFPA) (2004) Working from within: culturally sensitive approaches in UNFPA Programming www.unfpa.org/upload/lib_pub_file/268_filename_Cult ure_2004.pdf.

United Nations, Millenium Development Goals. http://www.un.org/millenniumgoals/pdf/MDG%20Report%202010%20En%20r15%20-low%20res%2020100615%20-.pdf#page=42.


Van Binsbergen, W. (1987). Chiefs and the state in independent Zamba Exploring the Zambian National Press https://www.openaccess.leidenuniv.nl/bitstream/1887/8990/1/ASC_1239806_055.pdf.

Van der Colff, L. (2003). Leadership lessons from the African tree. Management Decision, 41/3, 257-261, http://www.emeraldinsight.com/Insight/ViewContentServlet?Filename=Published/EmeraldFullTextArticle/Pdf/0010410306.pdf.

Vidyarthi, V. & Wilson, P. a. (2008). Development from within. Facilitating collective reflection for sustainable change. Xlibris Corporation.

Vygotsky, L. S. (1997). The collected works of L.S. Vygotsky. Vygotsky, L. S. (1999). Tool and sign in the development of the child.

The collected works of LS Vygotsky, 6, 3-68. Wallace, T. (2004). Inform, inspire, encourage: A guide to producing effective

HIV/AIDS materials. Action Aid International Wertsch, J.V. (1998). Pedagogy, Symbolic Control and Identity: theory,

research, Critique by Basil Bernstein. Language in Society, 27(2), 257-259, http://www.jstor.org/stable/4168837, (retrieved 12112013)

Wertsch, J.V. (2007). Mediation. In The Cambridge companion to Vygotsky, Edited by: Daniels, H., Cole, M. & Wertsch, J. V. 178–92. New York: Cambridge University Press.

World Bank (2004). State-Society Synergy for Accountability: Lessons for the World Bank. Herdon. VA., USA. World Bank.

World Bank (2004a). Country Assistant Strategy for the Republic of Zambia http://www-wds.worldbank.org/servlet/WDSContentServer/WDSP/IB/2004/04/23/000160016_20040423185130/Rendered/INDEX/276540ZM.txt

World Bank. (2005). Education Sector Response: A review of World Bank Assistance, http://siteresources.worldbank.org/INTHIVAIDS/Resources/375798-1103037153392/EducandAIDS.pdf (retrieved 150307)

Yamba, B., Namakhwa, S, & Bamusi, N. (2004). Recognizing the essential role traditional leaders play is critical to mobilizing grass root communities for sustainable, self- owned and effective HIV/AIDS and Orphans programs. Int. Conf. AIDS. 2004 Jul 11-16; 15: abstract no. MoPeE4270 http://gateway.nlm.nih.gov/MeetingAbstracts/102280550.html

Yin. R. K. (2009). Case Study Research: Design and Methods. SAGE Publications. California.

Zambia Central Statistical Office (2008) Zambia Demographic and Health Survey (ZDHS) 2007, Preliminary Report, Tropical Disease Research Centre, Ministry of Health MOH), University of Zambia.

Zambian Constitution, (1996), Part, XIII, Chiefs and House of Chiefs pp.127-137: The Institution of Chiefs, http://www.thezambian.com/Constitution/1996partxiii.aspx

Appendices

Appendix A: Selected demographic indicators

Selected demographic indicators from the National profile. The percentage column indicates the difference between 2005 and 2007.

Demographic indicators: 2005 2006 2007 %

Total projected population 11,441,461 11,798,678 12,160,516 10,6 Population 15-64 52,4% 52,5% 52,5% --- Children 6-13, 3,980,049 4,095,115 4,212,916 10,6 Children 14-17, 2,640,340 2,728,780 2,819,787 10,7 Adult HIV population 1,200,000 1,300,000 1,482,228 12,4 Paediatric HIV population 60,000 70,000 82,825 13,8 Newly symptomatic adults 95,818 96,108 96,494 10,1 Newly symptomatic children 5,500 5,700 6,086 11,1 Adult HIV Deaths 95,373 96,202 97,494 10,2 Paediatric HIV deaths 6,000 7,000 8,283 13,8 Adult HIV prevalence 13,9% 13,5% 13,1% 10,6 Pregnant women HIV prevalence 19,1% 19,1% 19,3% 10,1 Number of OVC 1,197,867 1,241,368 1,291,079 10,8

Source: MOH, NAC, 2008, p.iv.


Appendix B: Estimated annual HIV incidence

Estimated annual HIV incidence in adults aged 15-49 years in Zambia (1980-2010)

Source: Central Statistics Office (2008) - 2008 HIV and AIDS projections report, in UNGASS, 2010, p 32.

Appendices

289

Appendix C: Zambian education structure

Age Ed. Yr Type of schooling Others

30 24

University

Education: (Doctorate, masters and

Bachelors Degrees)

Continuing Education

& Literacy

18 12 High School (Grade 10-12)

Vocational training

programmes 17 11 16 10 15 9

B

asic

Upper Basic (Grade 8-9) Middle Basic (Grade 5-7) Lower Basic (Grade 1-4)

14 8 13 7 12 6 11 5

10 4

9 3

8 2

7 1 Pre-School Education Source: based upon Danida (2006) MOE, (2002, 2003) and UNDP (2010)


Appendix D: Basic education indicators

S/N Indicators Baseline 2002 Status 2006 Preliminary,

Danida

*Status 2007, (MOE, 2008, DRAFT)

Work Plan and Budget (2008)

M F T M F T M F T

1 Gr. Enrol. rate (Gr. 1-7) 97.4 89.9 93.6 124.72 121.19 122.96 130.00 2 Gr. Enrol. rate (Gr. 1-9) 87.4 80.1 83.7 111.09 106.43 108.76 S 123,04 115,57 119.29 3 NER (Gr. 1-7) 78.8 76.4 77.7 96.16 97.87 97.02 S 102,74 101,69 102,21 4 NER (Gr. 1-9) 76.8 72.7 74.8 94.99 94.96 94.98 27.54% 21.60% 24.55% 5 NER (Gr. 10-12) S 27.55% 20.33% 23.87% 6 Gross Intake rate Gr. 1 105.8 105 105.4 132.86 137.84 135.34 143.27% 145.35% 144.31% 7 Net Intake rate Gr. 1 40.0 42.2 41.1 48.67 52.33 50.49 S130,48 134,79 132,62 8 Completion rate Gr. 7 70.5 58.2 64.3 90.82 79.15 84.96 58.36% 57.39 % 57.88% 9 Completion rate Gr. 9 38.8 31.9 35.3 47.09 39.20 43.12 S54.79% 59.68% 57.22% 10 Trans.(Prom.) rate (7-8) 53.7 55.9 54.7 50.77 53.67 52.09 96.93% 84.43% 90.66% 11 Retention rate Gr. 1-7 67.80 55.30 61.44 S100.30% 90.49% 95.36% 12 Retention rate Gr. 1-9 32.51 26.29 29.35 50.73% 43.32% 47.00% 13 Drop-out rate Gr. 7 2.75 5.65 4.08 S56.02% 46.87% 51.40% 14 Drop-out Gr. 9 3.08 6.13 4.48 1.99% 2.89% 2.43% 15 Drop-out Gr. 1-9 S1.66% 2.76% 2.19% 16 Repetition Rate Gr. 1-9 7.42% 6.68% 7.06% 17 Out of school Gr. 1-7 2.58 0.68 1.63 S 10.62% 8.82% 9.74% 18 Out of school child. 1-9 4.39 4.31 4.35 333,433 322,519 655,952 19 Orphans Basic 1-9 643,010 S43,942 41,809 85,751 20 Orphans Gr. 10-12 285,641 279,612 565,253

21 No. Pupils Receiving Bursaries Gr. 1-9 S3,899 3,188 7,087

Source: from DANIDA (2006), and, MOEZ*, (2008)

Appendices

291

Appendix E: HIV/AIDS as addressed in the syllabi

As mentioned earlier, HIV/AIDS is one among a range of cross cutting issues in the Zambian Basic Education Syllabi, Grade 1-7 from 2003. In the table below all issues addressing HIV/AIDS are quoted, by Learning Area and grade. “Alt” Indicates that HIV/AIDS is mentioned as an optional subject. S.A. indicates HIV/AIDS education as a given subject area.

Language

Alt.

Grade1

Describe common illnesses such as malaria and HIV/AIDS (p.6)

Alt. Read storybooks and other materials on road safety, HIV/AIDS, Hygiene etc. (p.7).

Alt. Write meaningful stories based on posters depicting topical issues such as HIV/AIDS, corruption, child abuse, road safety (p.7)

Alt. Grade2 Write short stories based on known events, own experiences, imagination, pictures and folk tales (environment, child abuse, HIV/AIDS, road safety) (p.10)

Alt. Grade4 Compose a story on topical issues such as HIV/AIDS, child abuse, corruption, substance abuse (p.14)

Alt. Grade5 Debate cross cutting issues and themes such as health, environmental issues, gender, HIV/AIDS, child abuse, etc. (p.15)

Alt.

Grade6

Report facts on an issue, e.g. HIV/AIDS, Human Rights, Democracy (p.18)

Alt.

Identify, classify and use information about countries, people, customs, law and order, agriculture, conservation, current affairs, historical subjects and topical issues such as HIV Democracy, gender, Governance (p.18)

Alt.

Grade7

Debate issues of national importance suh as Corruption, Governance, Child abuse, Substance abuse, Human rights, Environmental issues, HIV/AIDS using formal procedures (21)

Alt. Narrate stories, tales, legends and myths on Gender, HIV/AIDS etc (p.22)

Alt. Answer and pose questions on any cross-cutting issue (HIV/AIDS gender, Substance abuse, Child abuse, Water and Sanitation etc) (p.22)


Integrated Science

S.A. Grade1

State what the letters HIV/AIDS stands for (p.26)

S.A Mention ways through which HIV can be passed on from an infected person to a person who is not infected (p.26)

S.A.

Grade2

State what HIV/AIDS stands for (p.30) S.A. Discuss how HIV transmission through blood can be prevented (p.30)

S.A. Explain why it is not good to touch human blood and to share sharp instruments (razor blades, needles.) (p.30)

S.A. Grade3 Distinguish between infectious and non-infectious diseases (TB, AIDS, measles and malaria, p.33)

S.A. Grade4 Discuss how HIV/AIDS and Sexually Transmitted Infections are contracted (p.36)

S.A.

Grade5

Discuss ways in which HIV and STIs are transmitted (p.40)

S.A. Discuss what happens to the body when an HIV positive person develops AIDS (p.40)

S.A. Discuss the care and treatment of AIDS patients (nutritious meals, p.40)

Alt.

Grade7

Discuss the effects of diseases on the population (cholera, tuberculoses, malaria, HIV/AIDS, p.48)

Alt. Discuss the effects of cholera, tuberculoses, malaria, HIV/AIDS on individuals and families (p.47)

S.A. Explain why HIV and AIDS is a threat to Zambians (p.47) Creative and technology studies

Alt. Grade1 Sing traditional songs on HIV/AIDS, Gender and Child abuse (p.56) S.A.

Grade2 Discuss how to prevent HIV infections (p.57)

Alt. Sing songs that express facts on HIV/AIDS, evils of corruption, Child abuse (p.59)

Alt. Grade3

Sing a variety of traditional and contemporary songs on HIV/AIDS, child abuse, road safety, substance abuse and governance (p.62)

Alt. Draw pictures based upon a given theme (HIV/AIDS, Gender, Governance, water and sanitation, p.61)

Alt. Grade4 Sing a variety of traditional and contemporary songs on various cross-cutting issues such as HIV/AIDS, gender, water and sanitation, nutrition, health and governance (p.66)

Alt. Grade5 Make posters using different typefaces on different crosscutting issues such as HIV/AIDS, gender, substance abuse, child abuse, water and sanitation, nutrition and health (p.70)

Alt. Grade6

Compose songs based on various themes using rhythmic and harmonic melody lines (e.g.HIV/AIDS, child abuse, water sanitation, human rights, governance, gender, substance abuse, nutrition and health, road safety, p.75)

Mathematics: (Section E), nothing highlighted Social and Development studies (Section: F) S.A. Grade7 Explain the consequences of HIV/AIDS on food security (p.121)


Appendix G: Global Campaign for Education (GCE 2005)

A survey by Global Campaign for Education (GCE 2005) on MOE’s response to the HIV/AIDS epidemic in 18 selected countries1 revealed that only 2, Zambia being one, that had implemented a coherent educational sector HIV/AIDS strategy. The majority of governments were in general turning a blind eye to the orphans and HIV positive, and donor aid was not helping governments to address these problems systematically within the sector. HIV/AIDS education rather tended to be directed towards “stand alone” initiatives with limited governmental or local ownership.

These findings are supported by a global study conducted by IBE (2004) in 36 countries, where one third had adopted a complete HIV/AIDS policy framework and only two additional countries had made progress in developing such a framework (Putzel, 2004). UNAIDS Interagency Task Team on Education (2005) conducted a survey about HIV/AIDS education in seventy countries. Fifty-five countries reported having addressed HIV/AIDS in the curriculum at primary level, and sixty-two at secondary level. The evidence on implementation and impact is mixed. In another survey of eighteen low-income countries, nearly all had developed an HIV/AIDS curriculum but implementation was limited (UNESCO 2008).

The responses by the Ministries of Education (MOEs) reflected the general findings related to HIV/AIDS prevention as described earlier HIV/AIDS falls between different ministries basically health and education, where health initiative up to now has been the prominent actor in fighting HIV/AIDS. The HIV/AIDS units within Ministries if Education tend to be isolated, under-resourced and lacking power to implement the HIV/AIDS activities within the sector. At the same time, MOEs do not have access to the evidence base needed to formulate effective policies and are not engaging systematically with civil society to design HIV/AIDS policies.

Responses addressing issues of curricular and teaching aspects of HIV/AIDS reflecting possible school level initiatives showed that nearly all countries had developed an HIV/AIDS curriculum with support from UNESCO, UNICEF and/or another international partner, but the implementation was very limited and not integrated into the general syllabus. One were also complaining about the lack of involvement by the civil society and teachers in the development of the material, lack of distribution of teaching materials and lastly complains about the insufficient investment in pre-, in-service training of teachers (GCE 2005).

1 Bolivia, Burundi, ElSalvador, Gambia, Ghana, Haiti, Kenya, Mali, Nepal, Nigeria,

Senegal, Tanzania, Togo, Uganda, Zambia and Zimbabwe

Appendices

295

In 17 out of 18 countries there were some partnership between MOEs and the civil society through NGOs, the partnerships were informal and depended more upon individuals than formal institutional cooperation. In most cases health sector paid little attention to the role of the education sector, and it was stressed the need to strengthen the capacity of coalitions to develop partnerships (GCE 2005). Putzel (2004) also argued that the international donor community and African governments still were leaving much of the response to officials responsible for health sector in fighting HIV/AIDS. This is also indicated in the Global Monitoring Report saying that:

while the evidence on the potential effectiveness of school-based health and nutrition interventions is persuasive, success depends on several conditions: (i) the programmes are explicitly linked with education sector priorities to ensure commitment to their implementation; (ii) there is a formal, multisectoral policy to ensure that health workers do not resist the delivery of interventions by teachers (UNESCO 2008:124).

The tension between the two sectors, education and health is addressed in the multisectoral strategy the global environment has applied to in fighting the HIV/AIDS pandemic.

GCE (2005) also concludes with pointing at the overall lack of coordination of the HIV/AIDS preventive efforts in the 18 countries surveyed, at all levels. Most of the organisations were running their HIV/AIDS preventive educational programs and projects based upon their own individual ideologies and beliefs, focusing on tackling immediate symptoms rather than underlying contextual and structural causes. The report (GCE 2005) advocates for a programmatic response by the ministries to the fight the HIV/AIDS epidemic along the recommendations put forth by among others, UNESCO (2000a), UNESCO (2008) UN (2011) and UNGASS 2001(in Schenker 2004). Recent research reveals that globally, comprehensive and correct knowledge about HIV among both young men and young women has increased slightly since 2008, but at only 34 percent, the number of young people with this comprehensive knowledge is barely one third of the overall UNGASS target of 95 percent (UN 2010 Global Report).

Appendices

297

Appendix I: Baseline survey tools

A: Matrix, School Mapping

School data Teaching materials/ types/ numbers

HIV/AIDS progr

Cap.building act.

Gaps identified

Distr.

Clust. Sch. HT Numb.T. Numb. P.

B: Questionnaire, school/community-level, HT, teachers, PTAs, Chiefs School-mapping: Selected schools with/without having teacher students conducting HIV/AIDS awareness raising

1. Sex

2. Position (HT, teacher, PTA, Chief)

3. For how long have you had this position?

4. Previous position

5. Your role in HIV/AIDS prevention las year

6. Any HIV/AIDS capacity building last year? (when, what, duration)

7. Outcome and any follow up after the training?

8. Any evaluation and/or monitoring in place? What?

9. Impacts of any School- or community activity mitigating HIV/AIDS?

10. Is HIV/AIDS seriously dealt with? How? Who are the main actors?


C: Principles, questionnaire (Total= 17, K=10, L=17)

School: Age/gender:

1. Are you involved in HIV/AIDS education, if yes, how? 2. Have you received any training in how to teach HIV/AIDS? What kind, By whom? 3. What kind of HIV/AIDS materials are you using? Anything provided to the schools?

To the teachers? 4. Do the school has its own HIV/AIDS educaton strategy, how was it developed? 5. What do you emphasise in teaching HIV/AIDS and why? 6. Do you integrate HIV/AIDS in your tecahing subjects, explain 7. Which teachers do you think should handle HIV/AIDS? Why? 8. What do you think influences teachers involvement in the teaching of HIV/AIDS

education (HAE)? 9. Is it important for the teachers to get involved in HIV/AIDS education? Explain 10. What do you think are your fellow teachers’views on HIV/AIDS education? 11. What are the constraints that affect the provision of school-based HIV/AIDS

education in your school? 12. What problems do you face in your involvement in HIV/AIDS education? 13. What are the benefits of teaching HIV/AIDS education in school? 14. Are all your collegues involved in HIV/AIDS education? Why do you think somebody

would not engage themselves in HIV/AIDS education? 15. How to enhance the involvement of teachers in HIV/AIDS education?

Any other comments regarding HIV/AIDS education? 16. Comments about teaching HIV/AIDS in single sex groups? 17. Comments about teaching HIV/AIDS in mixed groups? 18. How do you interact with students in relation to HIV/AIDS? 19. Did you have teacher- students from DALICE at your school?

If yes, how did they contribute in the area of HIV/AIDS? 20. How would you asess the impact on HIV/AIDS educaton among staff members,

on the pupils and on the parents/community?

Appendices

299

D: Teachers’ Qustionnaire Total 25 (LW=8, M=9, N=9) by age, gender

School: Age/Gender:

1. Are you involved in HIV/AIDS education, if yes how? 2. Have you received any training in how to teach HIV/AIDS? What kind, by whom? 3. What kind of HIV/AIDS materials are you using? Anything provided to the schools?

To the teachers? 4. Do the school has its own HIV/AIDS education strategy, how was it developed? 5. What do you emphasise in teaching HIV/AIDS and why? 6. Do you integrate HIV/AIDS in your teaching subjects, explain 7. Which teachers do you think should handle HIV/AIDS? Why? 8. What do you think influences teachers involvement in the teaching of HIV/AIDS education? 9. Is it important for the teachers to get involved in HIV/AIDS education? Explain: 10. What do you think are your fellow teachers‘views on HIV/AIDS education? 11. What are the constraints that affect the provision of school-based HIV/AIDS education

in your school? 12. What problems do you face in your involvement in HIV/AIDS education? 13. What are the benefits of teaching HIV/AIDS education in school? 14. Are all your collegues involved in HAE? Why do you think somebody would not

engage themselves in HIV/AIDS education? 15. How to enhance the involvement of teachers in HAE? Any other comments

regarding HIV/AIDS education? 16. Comments about teaching in single sex 17. or mixed groups? 18. How do you interact with students in relation to HIV/AIDS? 19. Did you have student teachers from (nearbying college) at your school?

If yes, how did they contribute in the area of HIV/AIDS education? 20. How would you assess the impact on HIV/AIDS education among staff members,

on the pupils and on the parents/community?


Appendix J: Quarterly monitoring of HIV/AIDS activities.

Southern Province, MOEZ/UFD cooperation, 2005. PEMC/FTA.

District: Name of school: Name of Principal: Term: Quarter:

1 What is the school policy on HIV/AIDS Education,

HAE?

2 Which other schools, institutions, organisations or others are you networking with on HAE and how?

3 How much time is allocated to HAE weekly? a) Targeting the pupils? b) Targeting the teachers? How?

A) B)

4 A) What kind of HAE education are being run at school targeting all pupils during a quarter? B) Who is organising/responsible for these activities? C) Target group (and numbers)

(use the next page if needed):

5 A) What kind of HAE is based upon Vulentarely participation by pupils? B) Who is organising these activities? C) Target group and numbers

(use the next page if needed):

6 How many teachers are teaching HAE? Male: Female:

7. How many teachers are practicing interactive methodology?

Male: Female:

8. A) What kind of HAE material do you have in your school? B) How many of each?

A) B)

9. Teachers abcenteism, quarterly (number of days/hours.)

(if needed, use the next page)

Grade Female: Male:

10. Pupils abcenteism, quarterly(number of days/hours)

(if needed, use the next page)

Grade: Female: Male:

11. Number orphans:

Single: Female: Male

12. Identify any income generating activity targeting the OVC. (use next page)

Double:

List of Publications

Studies in Comparative and International Education (ISSN 0348-9523) X:\interped_common\PhD\List_of_Publications.doc

1. Sixten Marklund Educational Administration and Educational Development, ISBN: 91-85996-00-2. October 1979

2. Sixten Marklund The Democratization of Education in Sweden. A UNESCO Case Study, ISBN: 91-85966-01-0. October 1980

3. Alex Gorham Education and Social Change in a Pastoral Society: Government Initiatives and Local Responses to Primary School Provision in Kenya Maasailand, ISBN: 91-85966-02-9. December 1981

4. Ulla Kann Career Development in a Changing Society: The Case of Botswana, ISBN: 91-85966-03-7. March 1981

5. Mauno Mbamba Primary Education for an Independent Namibia: Planning in a Situation of Uncertainty and Instability, ISBN: 91-22-0661-7. March 1982

6. Roland Duberg Schooling, Work Experience and Earnings: A Study of Determinants of Earning in a Third World Corporate Setting, ISBN: 91-85966-05-3. June 1982

7. Ann-Margret Fris Policies for Minority Education: A Comparative Study of Britain and Sweden, ISBN: 91-85966-06-1. October 1982

8. Vinayagum Chinapah Participation and Performance in Primary Schooling: A Study of Equality of Educational Opportunity in Mauritius, ISBN: 91-7146-417-4. September 1983

9. Kjell Nyström Schooling and Disparities: A Study of Regional Differences in Sri Lanka, ISBN: 91-7146-453-0. November 1985

10. Ingemar Gustafsson Schools and the Transformation of Work: A Comparative Study of Four Productive Work Programmes in Southern Africa, ISBN: 91-7146-479-4. 1987

11. Vasilios Makrakis Computers in School Education: The Cases of Sweden and Greece, ISBN: 91-7146-398-4. March 1988

12. Agneta Lind Adult Literacy Lessons and Promises: Mozambican Literacy Campaigns 1978-1982, ISBN: 91-7146-587-1. July 1988

13. Birgit Negussie Traditional Wisdom and Modern Development: A Case Study of Traditional Peri-Natal Knowledge among Elderly Women in Southern Shewa, Ethiopia, ISBN: 91-7146-712-2. December 1988

14. Anton Johnston Study, Produce and Combat! Education and the Mozambican State 1962-1984, ISBN: 91-7146-720-3. March 1989

15. Christine McNab Language Policy and Language Practice: Implementation Dilemmas in Ethiopian Education, ISBN: 91-7146-732-7. April 1989

16. Wendy Duncan Engendering School Learning: Science, Attitudes and Achievement Among Girls and Boys in Botswana, ISBN: 91-7146-75-8. April 1989

17. Eva Olkiewicz Invandrarfamiljer i förändring: En studie över finska och jugoslaviska invandrar-ungdomar och deras föräldrar, ISBN: 91-7146-836-6. April 1990

18. Hanne Bang Religious Identity over Two Generations: Roman Catholic Immigrant and Convert Families in Sweden, ISBN: 91-7146-834-X. April 1990

19. Maria Emília Catela Education Reform and Political Transition: A Study of Change in Portuguese Education in the 1970s, ISBN: 91-7146-842-0. July 1990

20. Ingemar Fägerlind, Sixten Marklund and Vinayagum Chinapah (eds) Torsten Husén. An Educator, ISBN: 91-630-0377-5. 1991

21. Ulla Sirén Minority Language Transmission in Early Childhood: Parental Intention and Language Use, ISBN: 91-7146-920-6. May 1991

22. Alf Carlsson Cooperatives and the State: Partners in Development? A Human Resource Perspective, ISBN: 91-7153-013-4. May 1992

23. Vinayagum Chinapah (ed.) Strategies and Modalities for Educational Financing in Africa, ISBN: 91-7153-049-5. December 1992

24. Holger Daun Childhood Learning and Adult Life: The Functions of Indigenous, Islamic and Western Education in an African Context, ISBN: 91-7153-062-2. 1992

25. Gary Miron Choice and the Use of Market Forces in Schooling: Swedish Education Reforms for the 1990s, ISBN: 91-7153-107-6. 1993

26. Zhao Shangwu Chinese Science Education: A Comparative Study of Achievement in Secondary Schools Related to Student, Home and School Factors, ISBN: 91-7153-119-X. 1993

27. Paul Pawar Training for the New Competition: Applications of Critical Theory to Industrial Relations Training in Kenya and Nigeria, ISBN: 91-7153-155-6. 1993

28. Jan-Åke Engström Science Achievement and Student Interest: Determinants of Success in Science among Swedish Compulsory School Students, ISBN: 91-7153-180-7. 1994

29. Geoffrey Nambira Educating Children with Hearing Impairments in Tanzania: Comparing Regular and Special Schools, ISBN: 91-7153-239-0. September 1994

30. Fatima Salah Media Selection: Measuring the Effectiveness of a Media Selection Procedure in Moroccan Secondary School Context, ISBN: 91-7153-240-4. 1994

31. Riita Eriksson Biculturalism in Upper Secondary Education: The Long Tern Effects of Finnish Language Programs on Students’ Educational and Occupational Careers, ISBN: 91-7153-238-2. June 1994

32. Gary Miron Special Needs Education in Nicaragua: A Study of the Prevalence of Children with Disabilities in Primary Schools and the Factors Affecting Their Successful Participation, ISBN: 91-7153-292-7. 1994

33. Nelly Kostoulas-Makrakis Language Maintenance or Shift? A Study of Greek Background Students in Sweden, ISBN: 91-7153-328-1. April 1995

34. Elisei Basil Temu Successful Schools in Tanzania: A Case Study of Academic and Production Programs in Primary and Secondary Schools, ISBN: 91-7153-382-6. 1995

36. Torsten Husén Printed Publications 1981 – 1995 (In Commemoration of his 80th Birthday), ISBN: 91-7153-439-3.1996

37. Xiaoda Chen Quality Schooling with Limited Resources: An International Comparison of Mathematics and Science Education in China, Korea and Hungary, ISBN: 91-7153-465-2. June 1996

38. Anne Welle-Strand Policy, Evaluation and Leadership: The Context of Educational Change in Zimbabwe, ISBN: 91-7353-468-7.June 1996

39. Sixten Marklund Printed Publications 1956-1996 (In Commemoration of his 75th Birthday), ISBN: 91-7153-507-1. September 1996

39. (a) Romanus Ejiaga Higher Education and the Labor Market: A Study of University Access and Graduate Employment Opportunities in Nigeria, ISBN: 91-7153-669-8. November 1997

40. (a) Paul Vedder and Mina O’Dowd Social Competence in Swedish Primary School Pupils: The Validity of the RCP-Scale, ISBN: 91-7153-560-8. 1996

40. Karen Sørensen Polish Higher Education En Rout to the Market: Institutional Change and Autonomy at Two Economics Academies, ISBN: 91-7153-672-8. December 1997

41. Luciana Benincasa A Journey, a Struggle, a Ritual: Higher Education and the Entrance Examinations in a Greek Province Town, ISBN: 91-7153-688-4. 1997

42. Anne Welle-Strand Educational Evaluation in Norwegian Development Aid: Does Competence in Education Make a Difference?, ISBN: 91-7153-730-9. 1998

43. Catherine A. Odora Hoppers Structural Violences as a Constraint to African Policy Formation in the 1990s: Repositioning Education in International Relations, ISBN: 91-7153-806-2. 1998

44. Liu Bing The State, Ethnic Identity and Education: A Study of Primary Schooling for Minorities in Xinjiang and Inner Mongolia in China, ISBN: 91-7153-832-1. November 1998

45. Teshome Nekatibeb Media Utilization and School Improvement: A Case Study of Primary Education Radio Support Programs in Ethiopia, ISBN: 91-7153-837-2. November 1998

46. Kah Slenning Future School Management. Do Plans and Needs Match? A Comparative Study with Examples from Four OECD Countries, ISBN: 91-7153-914-X. May 1999

47. Indra Dedze Reading Ability of Latvian Students. Results from an International Study, ISBN: 91-7153-981-6. October 1999

48. Ingemar Fägerlind, Içara Holmesland, and Görel Strömqvist (eds) Higher Education at the Crossroads: Tradition or Transformation?, ISBN: 91-7265-021-4. 1999

49. Mina O’Dowd The Changing Nature of Knowledge: Mapping the Discourse of the Malmö Longitudinal Study, 1939-1995, ISBN: 91-7265-088-5. May 2000

50. Alexander N. Kanaev Civic Education in Central Asia: Re-conceptualization of Citizenship in Newly Independent States, ISBN: 91-7265-083-4. 2000

51. Wycliffe H. Odiwour HIV/Aids and Primary Education in Kenya. Effects and Strategies, ISBN: 91-72-65-089-3. June 2000

52. Mina O’Dowd and Ingemar Fägerlind (eds) Mapping European Comparative Education Research Perspectives. The PRESTiGE TMR Network, ISBN: 91-7265-128-8. 2000

53. Yu Qiang Bilingual Education, Cognitive Development and School Achievement: A Study of the Bilingual Programs for Tibetan Children, ISBN: 91-7265-132-6. 2000

54. Wycliffe Humphrey Odiwuor The Impact of HIV/Aids on Primary Education. A Case Study of Selected Districts of Kenya, ISBN: 91-7265-140-7. Sep. 2000

55. Elizabeth F. Heen The Research University: Quo Vadis? Doctoral Research Training in Economics – Case Studies from France and Norway, ISBN: 91-7265-190-3. December 2000

56. Marit Storeng Giving Learners a Chance: Learner-Centredness in the Reform of Namibian Teaching, ISBN: 91-7265-236-5. March 2001

57. Emmanuel Boudard Literacy Proficiency, Earnings, and Recurrent Training: A Ten Country Comparative Study, ISBN: 91-7265-356-6. December 2001

58. Anne Smehaugen Inclusion & Exclusion in Culture, Learning and Education: A European Perspective. The Cases of Spain and Norway, ISBN: 91-7265-366-3. November 2001

59. Dinah Richard Mmbaga The Inclusive Classroom in Tanzania: Dream or Reality? ISBN: 91-7265-441-4. May 2002

60. Ulf Fredriksson Reading Skills among Students of Immigrant Origin in Stockholm, ISBN: 91-7265-460-0. May 2002

61. Ann-Kristin Boström Lifelong Learning, Intergenerational Learning, and Social Capital, ISBN: 91-7265-571-2. February 2003

62. Katrina Hugosson Working Life, Sustainable Health and Retirement for Women, ISBN: 91-7265-662-X. May 2003

63. Michiyo Kiwako Okuma-Nyström God Turns the Chapter and Everything Changes: Children’s Socialization in Two Gambian Villages, ISBN: 91-7265-656-5 ISSN: 0348-095-023. June 2003

64. Nuzzly Ruiz de Forsberg School Community Voices: Implementation of the Autonomous School Program in Nicaragua, ISBN: 91-7265-739-1 ISSN: 0348-095-023. October 2003

65. Richard Desjardins Learning for Well Being: Studies using the International Adult Literacy Survey, ISBN: 91-7265-792-8. March 2004

66. Lidija Kolouh-Westin Learning Democracy Together in School? Student and Teacher Attitudes in Bosnia and Hercegovina, ISBN: 91-7265-828-2. April 2004

67. Richard Desjardins, Christelle Garrouste-Norelius, Shawn Mendes Benchmarking Education and Training Systems in Europe, ISBN: 91-7265-915-7. June 2004

68. Lihong Huang Elitism and Equality in Chinese Higher Education. Studies of Student Socio-economic Background, Investment in Education, and Career Aspirations, ISBN: 91-7155-063-1. June 2005

69. Sheila Brooks Learning Motivation in International Primary Schools: The Voices of Children, ISBN: 91-7155-129-8. October 2005

70. Ernesto Villalba The uniqueness of knowledge management in small companies: Knowledge management as a strategy for lifelong learning, ISBN: 91-7155-252-9. June 2006

71. Mikiko Cars Project Evaluation in Development Cooperation: A Meta-Evaluative Case Study in Tanzania, ISBN: 91-7155-319-3. October 2006

72. Pia Karlsson & Amir Mansory An Afghan Dilemma: Education, Gender and Globalisation in an Islamic Context, ISBN: 978-91-7155-513-7.

73. Björn Söderqvist School Leaders’ View on Market Forces and Decentralisation: Case Studies in a Swedish Municipality and an English County, ISBN: 978-91-7155-510-6. November 2007

74. Christelle Garrouste Determinants and Consequences of Language-in-Education Policies: Essays in Economics of Education, ISBN: 978-91-7155-517-5. December 2007

75. Reza Arjmand Inscription on Stone: Islam, State and Education in Iran and Turkey, ISBN: 978-91-7155-728-5. October 2008

76. Åsa Brattlund What Role of God and National Curriculum in School Life? A Comparative Study of Schools with a Muslim Profile in England and Sweden, ISBN: 978-91-7155-849-7. April 2009

77. Shuting Gao Learner Support for Distance Learners. A study of six cases of ICT-based distance education institutions in China. ISBN: 978-91-7447-575-3. December 2012

78. Cresantus Nombo Biamba The Role of Principals in Government Secondary Schools in Cameroon: Demand, Constraints and Choices. A case study of eight secondary schools. ISBN: 978-91-7447-594-4. December 2012.

79. Ellen Carm Caught in Culture? Cultural transformation through HIV/AIDS prevention education in Zambia. ISBN Print: 978-91-7649-662-6, ISBN PDF: 978-91-7649-663-3. Mars 2017.

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